Journal ArticleDOI
Users' Guides to the Medical Literature: II. How to Use an Article About Therapy or Prevention B. What Were the Results and Will They Help Me in Caring for My Patients?
Gordon H. Guyatt,David L. Sackett,Deborah J. Cook,Gordon Guyatt,Eric Bass,Patrick Brill-Edwards,George P. Browman,Deborah Cook,Michael E. Farkouh,Hertzel C. Gerstein,Brian Haynes,Robert Hayward,Anne Holbrook,Roman Jaeschke,Elizabeth F. Juniper,Andreas Laupacis,Hui Lee,Mitchell Levine,Virginia Moyer,Jim Nishikawa,Andrew D Oxman,Ameen Patel,John Philbrick,W. Scott Richardson,Stephane Sauve,David L. Sackett,Jack Sinclair,K. S. Trout,Peter Tugwell,Sean Tunis,Stephen D. Walter,John W Williams,Mark C. Wilson +32 more
TLDR
A general internist is asked to see a 65-year-old man with controlled hypertension and a 6-month history of atrial fibrillation resistant to cardioversion, who has no evidence for valvular or coronary heart disease, and who shares concerns about the benefits of long-term anticoagulant therapy.Abstract:
CLINICAL SCENARIO You are a general internist who is asked to see a 65-year-old man with controlled hypertension and a 6-month history of atrial fibrillation resistant to cardioversion. Although he has no evidence for valvular or coronary heart disease, the family physician who referred him to you wants your advice on whether the benefits of long-term anticoagulants (to reduce the risk of embolic stroke) outweigh their risks (of hemorrhage from anticoagulant therapy). The patient shares these concerns and doesn't want to receive a treatment that would do more harm than good. You know that there have been randomized trials of warfarin for nonvalvular atrial fibrillation and decide that you'd better review one of them.read more
Citations
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Users' Guides to the Medical Literature
Gordon H. Guyatt,Drummond Rennie +1 more
TL;DR: Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information to learn and decide how to modify their practice.
Journal ArticleDOI
Updated method guidelines for systematic reviews in the cochrane collaboration back review group.
TL;DR: The recommendations are divided in five categories: literature search, inclusion criteria, methodologic quality assessment, data extraction, and data analysis, and additional recommendations are included regarding assessment of clinical relevance, and reporting of results and conclusions.
Journal ArticleDOI
Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy.
TL;DR: Increasing the supply of pragmatic or practical clinical trials will depend on the development of a mechanism to establish priorities for these studies, significant expansion of an infrastructure to conduct clinical research within the health care delivery system, more reliance on high-quality evidence by health care decision makers, and a substantial increase in public and private funding forThese studies.
Journal ArticleDOI
2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group
TL;DR: Instead of recommending Levels of Evidence, this update adopts the GRADE approach to determine the overall quality of the evidence for important patient-centered outcomes across studies and includes a new section on updating reviews.
Journal ArticleDOI
Criteria for evaluating evidence on public health interventions
TL;DR: This paper asks whether and to what extent evaluative research on public health interventions can be adequately appraised by applying well established criteria for judging the quality of evidence in clinical practice.
References
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Clinical Epidemiology: A Basic Science for Clinical Medicine
TL;DR: Clinical Epidemiology is a book dedicated to H.L. Mencken, Kurt Vonnegut, Jr., Douglas Adams, and the Emperor's New Clothes and Physicians and others who wish to recognize key clinical epidemiologic features of the diagnosis and management of patients will benefit from reading.
Journal ArticleDOI
Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial.
Echt Ds,Philip R. Liebson,Mitchell Lb,Robert W. Peters,Obias-Manno D,Barker Ah,Arensberg D,Baker A,Lawrence S. Friedman,Greene Hl +9 more
TL;DR: There was an excess of deathsDue to arrhythmia and deaths due to shock after acute recurrent myocardial infarction in patients treated with encainide or flecainide.
Journal ArticleDOI
An assessment of clinically useful measures of the consequences of treatment.
TL;DR: The goal is to provide a clear picture of the individual components of the immune system and provide a strategy for individualized treatment of these components according to their Kesslerian importance.
Journal ArticleDOI
Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. Veterans Affairs Stroke Prevention in Nonrheumatic Atrial Fibrillation Investigators.
Michael D. Ezekowitz,Samuel L. Bridgers,Kenneth E. James,Nathan H. Carliner,Cindy Colling,Charles C. Gornick,Heidi Krause-Steinrauf,John F. Kurtzke,Sarkis M. Nazarian,Martha J. Radford,Frederick R. Rickles,Ralph Shabetai,Daniel Deykin +12 more
TL;DR: Low-intensity anticoagulation with warfarin prevented cerebral infarction in patients with nonrheumatic atrial fibrillation without producing an excess risk of major hemorrhage, and this benefit extended to patients over 70 years of age.
Journal ArticleDOI
Hemorrhagic Complications of Anticoagulant Treatment
TL;DR: There is good evidence that low-intensity oral anticoagulant therapy (targeted INR of 2.5; range, 2.0 to 3.0) is associated with a lower risk of bleeding than therapy targeted at a higher intensity, and Lower-intensity regimens (INR 70 years).
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Users' guides to the medical literature. ii: how to use an article about therapy or prevention a. are the results of the study valid ?
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