Abstract:
OBJECTIVE:To examine the extent to which changes in diagnostic methods and classification are responsible for the striking increase in incidence of primary liver cancer in Denmark since 1943. DESIGN:Analysis of the time trends in sex specific, age standardised incidence of primary liver cancer and unspecified liver cancer (either secondary without known primary cancer or not specified as primary cancer) in the entire population from 1943 to 1985. By review of the 727 notifications from three periods of 5 years (1948-52, 1963-7, and 1978-82) the changes in histological diagnosis and classification were assessed. SETTING:Denmark. SUBJECTS:Notifications of liver cancer to the Danish cancer registry. RESULTS:Concomitant with the increase in primary liver cancer, the incidence of the unspecified liver cancer declined. The proportion of histologically diagnosed primary liver cancer rose from 85% to 98%, whereas the proportion for unspecified liver cancer rose from 12% to 51%. When the proportion of primary versus unspecified liver cancer obtained by histological diagnosis was extrapolated to all cases, the annual incidence of primary liver cancer was 4.4 rather than 1.6 per 100,000 population in 1948-52 and 6.0 rather than 5.5 per 100,000 in 1978-82. CONCLUSION:The increase in the incidence of primary liver cancer may be much smaller than the numbers of registered cases indicate. This example emphasises the need to consider diagnostic drift in time trend studies of disease incidence.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Anderson IB,Sørensen TI,Prener Adoi
10.1136/bmj.302.6774.437subject
Has Abstractpub_date
1991-02-23 00:00:00pages
437-40issue
6774eissn
0959-8138issn
1756-1833journal_volume
302pub_type
杂志文章abstract:OBJECTIVES:To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. DESIGN:Controlled trial randomised by practice. SETTING:General practices in Perth, Western Australia. PARTICIPANTS:468 general practitioners in 223 practice...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.327.7411.375
更新日期:2003-08-16 00:00:00
abstract:OBJECTIVE:To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. DESIGN:Randomised trial. SETTING:Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. PARTICIPANTS:One consultant in an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c6801
更新日期:2010-12-09 00:00:00
abstract:OBJECTIVE:To determine the most effective tocolytic agent at delaying delivery. DESIGN:Systematic review and network meta-analysis. DATA SOURCES:Cochrane Central Register of Controlled Trials, Medline, Medline In-Process, Embase, and CINAHL up to 17 February 2012. STUDY SELECTION:Randomised controlled trials of toco...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e6226
更新日期:2012-10-09 00:00:00
abstract:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.325.7370.925
更新日期:2002-10-26 00:00:00
abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e1442
更新日期:2012-03-12 00:00:00
abstract::Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.h4263
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVE:To determine whether tobacco smoking causes increased DNA modification (adducts) in human cervical epithelium. DESIGN:Comparison of DNA adducts measured by the technique of postlabelling with phosphorus-32 in normal ectocervical epithelium of smokers and non-smokers. A questionnaire on smoking habit and a ur...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6890.1444
更新日期:1993-05-29 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs. DESIGN:Retrospective cohort and nested case-control study. SETTING:Umbria region, Italy. PARTICIPANTS:400 000 current, recent, and past users (almost 2 million prescriptions) o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7405.18
更新日期:2003-07-05 00:00:00
abstract:OBJECTIVES:To determine the prevalence and associations of symptoms of fatigue. DESIGN:Questionnaire survey. SETTING:London general practice. PARTICIPANTS:611 General practice attenders. MAIN OUTCOME MEASURES:Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS:10.2% Of men (17/167) and 10.6% o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6762.1199
更新日期:1990-11-24 00:00:00
abstract:OBJECTIVE:To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN:11 year longitudinal clinical and laboratory study. SETTING:A haemophilia centre. PATIENTS:111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES:Symptoms of HI...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6810.1093
更新日期:1991-11-02 00:00:00
abstract:OBJECTIVE:To identify the nature and extent of any vocational training deficit within the London initiative zone and investigate the reasons. DESIGN:Collation of statistics and postal questionnaire surveys. SETTING:Thames regions inside and outside the London initiative zone. SUBJECTS:General practice registrars, tr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7023.97
更新日期:1996-01-13 00:00:00
abstract:OBJECTIVE:To determine whether use of tinzaparin, a low molecular weight heparin introduced for prophylactic management of deep vein thrombosis, increases the risk of serious postoperative bleeding leading to a higher than expected 28 day readmission rate after discharge for hysterectomy. DESIGN:Retrospective case-con...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38783.624444.55
更新日期:2006-04-08 00:00:00
abstract::The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.h4065
更新日期:2015-09-21 00:00:00
abstract:OBJECTIVE:To determine the association of resting echocardiography before elective intermediate to high risk non-cardiac surgery with survival and length of hospital stay. DESIGN:Population based retrospective cohort study. SETTING:Acute care hospitals in Ontario, Canada, between 1 April 1999 and 31 March 2008. PART...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d3695
更新日期:2011-06-30 00:00:00
abstract:OBJECTIVE:To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. DESIGN:Retrospective cohort study using conditional logistic regression (mat...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g4333
更新日期:2014-07-23 00:00:00
abstract::Objectives To estimate the short term effect of particulate air pollution (particle diameter <10 μm, or PM10) on mortality and explore the heterogeneity of particulate air pollution effects in major cities in China.Design Generalised linear models with different lag structures using time series data.Setting 38 of the ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j667
更新日期:2017-03-14 00:00:00
abstract:OBJECTIVE:To investigate the risks of adverse pregnancy and birth outcomes for treated and untreated bipolar disorder during pregnancy. DESIGN:Population based cohort study using data from national health registers. SETTING:Sweden. PARTICIPANTS:332,137 women with a last menstrual period anytime after 1 July 2005 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e7085
更新日期:2012-11-08 00:00:00
abstract:OBJECTIVE:To assess the impact on birth size and risk of low birth weight of alternative combinations of micronutrients given to pregnant women. DESIGN:Double blind cluster randomised controlled trial. SETTING:Rural community in south eastern Nepal. PARTICIPANTS:4926 pregnant women and 4130 live born infants. INTER...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7389.571
更新日期:2003-03-15 00:00:00
abstract:OBJECTIVES:To compile a register of diabetic patients within the catchment area of a district general hospital and evaluate the characteristics of the population using aggregated data from a general practice audit. DESIGN:Cross sectional study. Practices identified all known diabetics and completed a questionnaire fro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6911.1046
更新日期:1993-10-23 00:00:00
abstract:OBJECTIVE:To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING:Two defined geographical areas in south London. DESIGN:Annual period prevalent cases of psychosis were identified in 1993 in the study areas fr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7030.533
更新日期:1996-03-02 00:00:00
abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7276.1552
更新日期:2000-12-23 00:00:00
abstract:OBJECTIVE:To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN:Observational study. SETTING:Hospitals (n = 1487) participating in the Get With The Guidelines (GWTG)-Stroke program in the United States, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3786
更新日期:2015-07-31 00:00:00
abstract:OBJECTIVES: To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Conge...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.i4721
更新日期:2016-09-13 00:00:00
abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f866
更新日期:2013-02-13 00:00:00
abstract:OBJECTIVES:To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. DESIGN:Prospective intervention study which was later costed. SETTING:Inner city acci...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7042.1340
更新日期:1996-05-25 00:00:00
abstract:OBJECTIVE:To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN:Population based cohort study using within person analyses to control for confounding by indication. SETTING:Whole population of Sweden. PARTICIPANTS:7,917,436 people aged 15 and over, of whom 69,757 were t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h2388
更新日期:2015-06-02 00:00:00
abstract::Objective To determine whether educational attainment is a causal risk factor in the development of coronary heart disease.Design Mendelian randomisation study, using genetic data as proxies for education to minimise confounding.Setting The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3542
更新日期:2017-08-30 00:00:00
abstract:OBJECTIVES:To assess and improve the quality of care provided to women undergoing induced abortion. DESIGN:Two rounds of prospective, criterion based case note review audit. SETTING:Ten NHS gynaecology units throughout Scotland. SUBJECTS:2004 patient episodes of abortion care identified consecutively during two roun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.309.6946.15
更新日期:1994-07-02 00:00:00
abstract:OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CR...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e7666
更新日期:2012-12-06 00:00:00
abstract::Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in med...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6995.1663a
更新日期:1995-06-24 00:00:00