How should clinicians interpret clinical trials?

Abstract:

:Given the rapid evolution of cardiovascular medicine, clinicians must sift through an enormous array of information about new therapies in order to determine how best to treat patients with ischemic heart disease. They should first consider the evidence from randomized clinical trials, because these trials eliminate bias and permit broad statistical analyses. If randomized clinical trial data are not available, next in order of the strength of their evidence are observational studies, historically controlled studies, case series, and case reports. Clinicians must additionally ascertain that an investigation has the elements of good design, including a clear question, adequate sample size, appropriate inclusion and exclusion criteria, evidence that the right amount of data was collected carefully, and allowances in the analyses for patients taking multiple therapies and randomized into several clinical trials.

journal_name

Cardiol Clin

journal_title

Cardiology clinics

authors

Califf RM

subject

Has Abstract

pub_date

1995-08-01 00:00:00

pages

459-68

issue

3

eissn

0733-8651

issn

1558-2264

journal_volume

13

pub_type

杂志文章
  • Patent foramen ovale closure: historical perspective.

    abstract::The work of the pioneers in PFO closure finally may evolve into a front-line therapy for secondary prevention of stroke in selected patients who have PFO and embolic events. Current implants, although new to most of interventional cardiology and neurology, are the result of years of steady, progressive work. It seems ...

    journal_title:Cardiology clinics

    pub_type: 历史文章,杂志文章,评审

    doi:10.1016/j.ccl.2004.10.012

    authors: Kapadia SR

    更新日期:2005-02-01 00:00:00

  • The pathology of acute myocardial infarction: definition, location, pathogenesis, effects of reperfusion, complications, and sequelae.

    abstract::This article reviews the definition, locations, and pathogenesis of acute myocardial infarction and provides a review of the pathology of acute reperfusion therapy. Various complications and sequelae of acute myocardial infarction are also surveyed. ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Waller BF

    更新日期:1988-02-01 00:00:00

  • Treatment of Complex Thoracoabdominal Aortic Disease.

    abstract::Thoracoabdominal aortic aneurysms are increasing in incidence. Rupture is associated with a high rate of morbidity and mortality. The historic gold standard of open repair can be performed with low rates of complications at centers of excellence. However, these results are not universally achievable, with significantl...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2017.03.008

    authors: Kuo EC,Han SM

    更新日期:2017-08-01 00:00:00

  • Extended arch resection in acute type A aortic dissection: PRO.

    abstract::The number of supporters of complete arch replacement in the surgery of acute type A aortic dissection has been steadily increasing as a result of cerebral perfusion techniques that enable the extension of safe circulatory arrest time. However, there is no agreement in the surgical community on an optimal surgical app...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2010.01.007

    authors: Urbanski PP,Lenos A,Schmitt R,Diegeler A

    更新日期:2010-05-01 00:00:00

  • Percutaneous mechanical support for the failing right heart.

    abstract::Right ventricular (RV) failure is an increasingly common clinical problem that may require mechanical support. In contrast to severe left ventricular failure, RV failure is typically more reversible. Therefore, application of shorter-term percutaneous support devices is potentially attractive. Current innovations prom...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2012.03.007

    authors: Goldstein JA,Kern MJ

    更新日期:2012-05-01 00:00:00

  • Coronary chronic total occlusion.

    abstract::Chronic total coronary occlusions (CTOs) are a frequent finding in patients with coronary disease and remain one of the most challenging target lesion subsets for intervention. CTOs have been reported in approximately one-third of patients undergoing diagnostic coronary angiography. By nature of their complexity, CTO ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2009.10.003

    authors: Galla JM,Whitlow PL

    更新日期:2010-02-01 00:00:00

  • Controversies in heart failure. Are beneficial effects of angiotensin-converting enzyme inhibitors attenuated by aspirin in patients with heart failure?

    abstract::To whatever extent the improvement in symptoms and survival rendered by treatment with ACE inhibitors is attributable to their effects on the circulation and the kidneys, this benefit can be rescinded by concomitant administration of aspirin. Although some useful prostaglandin-independent actions may persist, shutting...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70246-0

    authors: Hall D

    更新日期:2001-11-01 00:00:00

  • The pulmonary artery catheter: a critical reappraisal.

    abstract::Balloon floatation pulmonary artery catheters (PACs) have been used for hemodynamic monitoring in cardiac, medical, and surgical intensive care units since the 1970s. With the availability of newer noninvasive diagnostic modalities, particularly echocardiography, the frequency of diagnostic pulmonary artery catheteriz...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2013.07.008

    authors: Gidwani UK,Mohanty B,Chatterjee K

    更新日期:2013-11-01 00:00:00

  • Valvular disease in the elderly.

    abstract::As the incidence of valvular disease in the elderly is increasing, understanding of its pathogenesis and natural progression as well as surgical approaches and device technologies are improving. Future studies are needed to develop medical interventions that slow or halt the degenerative valvular processes associated ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70061-8

    authors: Hinchman DA,Otto CM

    更新日期:1999-02-01 00:00:00

  • Three-dimensional echocardiography: an alternative imaging choice for evaluation of tricuspid valve disorders.

    abstract::This article presents an approach to real-time three-dimensional imaging of the tricuspid valve from three different views. This is followed by some representative cases that illustrate these views and some unique tricuspid valve abnormalities, including one case of corrected transposition. ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章

    doi:10.1016/j.ccl.2007.06.001

    authors: Ahlgrim AA,Nanda NC,Berther E,Gill EA

    更新日期:2007-05-01 00:00:00

  • Contemporary treatment of venous thromboembolic disease.

    abstract::Venous thromboembolism (VTE) is a potentially fatal condition and includes deep vein thrombosis and pulmonary embolism. The novel oral anticoagulants, which include the direct thrombin and factor Xa inhibitors, have been shown to be safe and effective for the treatment of VTE. Additional interventions include thrombol...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2014.09.007

    authors: Galanis T,Merli GJ

    更新日期:2015-02-01 00:00:00

  • New theories. Causes of dilated cardiomyopathy.

    abstract::Dilated cardiomyopathy is a heterogeneous disease, both clinically and genetically. Two genes responsible for X-linked DCM have been identified. Five genetic loci responsible for X-linked DCM have been identified. Five genetic loci responsible for autosomal dominant DCM have also been mapped but no genes identified so...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70037-0

    authors: Bachinski LL,Roberts R

    更新日期:1998-11-01 00:00:00

  • Renal considerations in cardiovascular drug therapy.

    abstract::The increasing number of patients with both cardiac and renal disease makes it important for the clinician to bear in mind the effect of both renal failure and peritoneal or hemodialysis on the handling of drugs. Guidelines are available for specific medications; however, they must be used in the light of the patient'...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Feinfeld DA,Frishman WH

    更新日期:1987-11-01 00:00:00

  • Medical treatment of the aorta. I.

    abstract::Diseases of the thoracic aorta are serious conditions that require close observations. Impressive advances in imaging modalities such as magnetic resonance imaging, computed tomography sacs, and transesophageal echocardiography have aided diagnosis and provided insights into the pathogenesis and natural history of tho...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70109-0

    authors: Fuster V,Andrews P

    更新日期:1999-11-01 00:00:00

  • Quality of life in patients with atrial fibrillation.

    abstract::Quality of life is discussed with focus on the importance of individual patient perspectives. Eight studies including at least one aspect of quality of life in patients with atrial fibrillation are reviewed with three approaches evident in assessing quality of life: patient interview, self-reported symptoms, and multi...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70307-6

    authors: Jenkins LS,Bubien RS

    更新日期:1996-11-01 00:00:00

  • Problems with implantable cardiac device therapy.

    abstract::Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2008.03.012

    authors: Kowalski M,Huizar JF,Kaszala K,Wood MA

    更新日期:2008-08-01 00:00:00

  • Role of the surface electrocardiogram in the diagnosis of patients with supraventricular tachycardia.

    abstract::In this era of interventional electrophysiology, the accuracy of the electrocardiogram in diagnosis of supraventricular tachycardia could be improved by detailed endocardial mapping and confirmed by results of radiofrequency catheter ablation. This article describes the electrocardiographic characteristics for differe...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70361-1

    authors: Chen SA,Tai CT,Chiang CE,Chang MS

    更新日期:1997-11-01 00:00:00

  • Treatment of Cardiorenal Syndrome.

    abstract::The treatment of cardiorenal syndrome is as complex as the various mechanisms underlying its pathophysiology. Randomized controlled data typically focus on the treatment of heart failure with cardiac specific endpoints and a lack of worsening renal function used as a surrogate for efficacy. When heart failure is consi...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2019.04.002

    authors: Rubinstein J,Sanford D

    更新日期:2019-08-01 00:00:00

  • Congenital Abnormalities of the Pericardium.

    abstract::Congenital abnormalities of the pericardium are a rare group of disorders that include congenital absence of the pericardium, pericardial cysts, and diverticula. These congenital defects result from alterations in the embryologic formation and structure of the pericardium. Although many cases are incidentally found, t...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2017.07.012

    authors: Parmar YJ,Shah AB,Poon M,Kronzon I

    更新日期:2017-11-01 00:00:00

  • Historical aspects of electrocardiography.

    abstract::One hundred years ago, Augustus Desiré Waller recorded the human electrocardiogram for the first time, using a capillary electrometer. Electrocardiography only became clinically relevant in 1901 when Willem Einthoven devised his string galvanometer for this purpose. Sir Thomas Lewis was the key figure in showing the v...

    journal_title:Cardiology clinics

    pub_type: 传,历史文章,杂志文章

    doi:

    authors: Krikler DM

    更新日期:1987-08-01 00:00:00

  • Atrial Septal Defects and Cardioembolic Strokes.

    abstract::Atrial septal defects (ASDs) can be complicated by cardioembolic strokes, but the exact incidence is unknown. Patients with large and small shunts may present with a cardioembolic stroke. Patients with cryptogenic strokes should have cardiac ultrasound to see if an ASD is present. Cardioembolic strokes associated with...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2015.12.004

    authors: Leppert M,Poisson SN,Carroll JD

    更新日期:2016-05-01 00:00:00

  • Clinical presentation of infective endocarditis.

    abstract::Despite the decline in rheumatic heart disease worldwide and the use of antibiotic prophylaxis, there is no evidence that the incidence of infective endocarditis is decreasing. In fact, some data suggest it may be increasing. The classical fever of unknown origin presentation represents a minority of infective endocar...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(03)00023-7

    authors: Crawford MH,Durack DT

    更新日期:2003-05-01 00:00:00

  • Factors contributing to the emergence of coronary thrombolysis.

    abstract::Coronary thrombosis is now recognized as the most common proximate cause of acute myocardial infarction, and thrombolysis is evolving as an accepted therapeutic approach to patients presenting in the early stages of myocardial infarction. The ascent of thrombolysis in treatment hierarchies reflects multiple factors, i...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Tiefenbrunn AJ,Sobel BE

    更新日期:1987-02-01 00:00:00

  • Physiologic changes during normal pregnancy and delivery.

    abstract::The major adaptations of the maternal cardiovascular system that progress throughout gestation may unmask previously unrecognized heart disease and result in significant morbidity and mortality. Most of these changes are almost fully reversed in the weeks and months after delivery. Hemodynamic changes during pregnancy...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2012.05.004

    authors: Ouzounian JG,Elkayam U

    更新日期:2012-08-01 00:00:00

  • Cardiotoxicity of Immune Therapy.

    abstract::The advent of immunotherapy, particularly immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy, has ushered in a promising new era of treatment of patients with a variety of malignancies who historically had a poor prognosis. However, these therapies are associated with potentially life-threatenin...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccl.2019.07.008

    authors: Ganatra S,Parikh R,Neilan TG

    更新日期:2019-11-01 00:00:00

  • Normal and abnormal rhythms associated with dual-chamber pacemakers.

    abstract::Except for the unique eccentricities of individual devices, most dual-chamber paced rhythms, both normal and abnormal, are readily understood and lend themselves to analysis if the programmed parameters are known. Although they may appear intimidating, this need not be the case if the physician is initially willing to...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Levine PA

    更新日期:1985-11-01 00:00:00

  • Integrated approach to ischemic heart disease. The one-stop shop.

    abstract::Magnetic resonance imaging is unique in its variety of applications for imaging the cardiovascular system. A thorough assessment of myocardial structure, function, and perfusion; assessment of coronary artery anatomy and flow; and spectroscopic evaluation of cardiac energetics can be readily performed by magnetic reso...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70012-6

    authors: Kramer CM

    更新日期:1998-05-01 00:00:00

  • Intravascular ultrasound and balloon percutaneous transluminal coronary angioplasty.

    abstract::Intracoronary ultrasound provides unique information during percutaneous transluminal coronary angioplasty (PTCA), including more accurate measurement of vessel size and plaque burden as well as plaque characteristics such as composition and distribution. As a research tool, it has been useful in determining the mecha...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70316-7

    authors: Tenaglia AN

    更新日期:1997-02-01 00:00:00

  • Clinical assessment and management of mitral stenosis.

    abstract::There have been significant advances in the diagnosis and treatment of the patient with mitral stenosis over the past two decades. Two-dimensional and Doppler echocardiography have supplanted the cardiac catheterization laboratory in the diagnosis and determination of the hemodynamic severity of the stenotic mitral va...

    journal_title:Cardiology clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0733-8651(05)70021-7

    authors: Bruce CJ,Nishimura RA

    更新日期:1998-08-01 00:00:00

  • Pulmonary vascularity on the plain chest radiograph.

    abstract::The most important factor in the interpretation of any heart lesion is the radiographic appearance of the pulmonary vessels (vascularity) and lung parenchyma. The author discusses several abnormalities; he focuses particularly on pulmonary venous hypertension. ...

    journal_title:Cardiology clinics

    pub_type: 杂志文章

    doi:

    authors: Elliott LP

    更新日期:1983-11-01 00:00:00