Abstract：
OBJECTIVES:To investigate cost savings from and implications of replacing the single risk with a total cardiovascular risk approach in primary prevention of cardiovascular disease (CVD). STUDY DESIGN AND SETTING:A cost analysis using data from the 2007-08 Jamaica Health and Lifestyle Survey of 1,432 persons aged 40 years and older with 10-year risk estimated from region-specific World Health Organization/International Society for Hypertension (WHO/ISH) CVD risk charts. The WHO/ISH and local treatment guidelines were used to cost lifestyle changes, medications, and provider visits. RESULTS:Use of the total cardiovascular risk approach was less costly regardless of age. Women showed greater cost disparity. However, if 10-year CVD risk was estimated without measured cholesterol, both approaches resulted in similar costs in men ≥60 years. The annual per capita cost of lifestyle recommendations, critical in the absence of pharmacotherapy, was estimated at US $869.05 for diet and US $80 for physical activity. This represents about a third of the annual income of a minimum wage earner. At the national level, implementation of the WHO/ISH total risk approach could reduce health care costs by US $5 million annually. CONCLUSION:Cost savings that mainly resulted from reduced care for women may lead to gender disparity in CVD outcomes.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Abdulkadri AO,Tulloch-Reid MK,Francis DK,Gordon-Strachan GM,Younger-Coleman NO,Rocke KD,McFarlane SR,Cunningham-Myrie CA,Ferguson TS,Wilks RJ,Anderson SGdoi
10.1016/j.jclinepi.2014.11.027subject
Has Abstractpub_date
2015-09-01 00:00:00pages
994-1001issue
9eissn
0895-4356issn
1878-5921pii
S0895-4356(15)00109-2journal_volume
68pub_type
杂志文章abstract：:To determine eligibility for a (randomized) clinical trial, measuring the inclusion and exclusion criteria can be extended over a period of time. During this period, known as the selection period, a patient is repeatedly examined at certain time intervals. This study describes an approach for optimizing the efficiency...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00069-3
更新日期：1997-07-01 00:00:00
abstract：:The aim of this cross-sectional study was to estimate the prevalence of iron deficiency and overload in the adult population in Iceland, a developed Scandinavian country. The study population consisted of 4240 individuals aged 25-74 years randomly selected from the national roster. Basic hematological, S-iron, S-total...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90090-v
更新日期：1991-01-01 00:00:00
abstract：:The objective of this study was to compare the relative responsiveness of a condition-specific spinal stenosis measure and two generic health status measures for outcome assessment of surgery for degenerative lumbar spinal stenosis, and to examine whether responsiveness statistics and measures of the ability to distin...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/0895-4356(95)00054-2
更新日期：1995-11-01 00:00:00
abstract：:Plasma fibrinogen was measured in a sample of 8824 men and women aged 40-59 years participating in the Scottish Heart Health Study, and related to cardiovascular risk factors. Women had higher fibrinogen levels than men. In both sexes, multivariate analysis showed that fibrinogen was positively associated with age, sm...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90075-z
更新日期：1990-01-01 00:00:00
abstract：:The objective of this study was to identify characteristics of non-respondents and late respondents to a mailed health survey. Persons who returned and those who did not return the questionnaire were compared using health insurance data, which indicated their age, sex, and health care expenditures in the previous year...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00166-2
更新日期：1997-10-01 00:00:00
abstract：:A truly international and systematic review (SR) identifies and synthesizes relevant evidence regardless of the geographical provenance or language of publication. Despite recommendations, international SRs continue to exclude papers in languages other than English (LOE) at searching, screening, and analysis phases ei...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.03.004
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:We consider the number needed to treat (NNT) when the event of interest is defined by dichotomizing a continuous response at a threshold level. If the response is measured with error, the resulting NNT is biased. We consider methods to reduce this bias. METHODS:Bias adjustment was studied usin...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2004.01.021
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:The impact of disease on population health is most commonly estimated by the population attributable fraction (PAF), or less commonly by the excess risk, an alternative measure that estimates the absolute risk of disease in the population that can be ascribed to the exposure. Using chronic airflow obstructio...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2017.10.020
更新日期：2018-01-01 00:00:00
abstract：:Period prevalence is frequently measured in studies based on administrative data such as that from health maintenance organizations. For example, treated prevalence and drug utilization prevalence are important measures that are typically defined in relationship to a specified time period. Often one wishes to compare ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(95)00573-0
更新日期：1996-04-01 00:00:00
abstract：OBJECTIVE:To demonstrate how decision analytic models (DAMs) can be used to quantify impact of using a (diagnostic or prognostic) prediction model in clinical practice and provide general guidance on how to perform such assessments. STUDY DESIGN AND SETTING:A DAM was developed to assess the impact of using the HEART s...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.07.010
更新日期：2019-11-01 00:00:00
abstract：:This paper reports a prospective study, carried out in elderly patients hospitalized for acute illness, designed to evaluate the effectiveness of medical treatment from the point of view of quality of life (QoL). Patient's autoperception and satisfaction with health, the most relevant subjective estimates of QoL, were...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00237-k
更新日期：1995-08-01 00:00:00
abstract：OBJECTIVE:To explore implications of using systematic drug class reviews to develop U.S. Medicaid drug formularies. We assess racial/ethnic, gender, and socioeconomic status (SES) concordance between Medicaid populations and studies synthesized in Drug Effectiveness Review Project (DERP) systematic reviews. STUDY DESI...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2009.01.009
更新日期：2009-12-01 00:00:00
abstract：:The purpose of this study was to relate the 1-year risk of death and development of acute myocardial infarction among diabetics with acute chest pain to whether they had a history of hypertension or not. All patients with a history of diabetes mellitus who, during 21 months, were admitted to the Emergency Room in Sahl...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)90174-0
更新日期：1994-07-01 00:00:00
abstract：:The clinical correlates of advanced retinopathy were determined in a sample of 427 type II diabetic outpatients, aged 35 to 74 years, recruited in eight centers from all parts of France. The presence of retinopathy was assessed by fluorescein angiography with centralized interpretation. Advanced retinopathy (prolifera...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,多中心研究
doi：10.1016/0895-4356(95)00582-x
更新日期：1996-06-01 00:00:00
abstract：OBJECTIVE:The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND SETTING:From current Cochrane collaboration systematic reviews in majo...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.11.003
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Epidemiologic studies commonly estimate associations between predictors (risk factors) and outcome. Most software automatically exclude subjects with missing values. This commonly causes bias because missing values seldom occur completely at random (MCAR) but rather selectively based on other (...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.01.009
更新日期：2006-10-01 00:00:00
abstract：OBJECTIVE:To determine the status of dementia care services and workforce in selected public and private hospitals and geriatric care facilities in the Philippines. STUDY DESIGN AND SETTING:Framework analysis of 54 key informant interviews, 4 focus group discussions, and survey of 167 workers in 26 purposively selecte...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2018.06.010
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVES:To evaluate meta-analyses with trial sequential analysis (TSA). TSA adjusts for random error risk and provides the required number of participants (information size) in a meta-analysis. Meta-analyses not reaching information size are analyzed with trial sequential monitoring boundaries analogous to interim m...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2007.10.007
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVES:The aim of the study was to investigate the effect of number of studies in a meta-analysis on the detection of publication bias using P value-driven methods. METHODS:The proportion of meta-analyses detected by Egger's, Harbord's, Peters', and Begg's tests to have asymmetry suggestive of publication bias wer...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.11.011
更新日期：2020-02-01 00:00:00
abstract：OBJECTIVE:To estimate the sensitivity of International Classification of Diseases (ICD-9-CM) coding for detecting hospitalized community-acquired pneumonia and to assess possible determinants for misclassification. STUDY DESIGN AND SETTING:Based on microbiological analysis data, 293 patients with a principal diagnosis...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2006.10.018
更新日期：2007-08-01 00:00:00
abstract：:In a community based, prospective study to determine risk factors for falls, 465 women and 296 men 70 years and over were followed for 1 year and 507 falls were documented. A greater proportion of women (32.7%) than men (23.0%) experienced at least one fall in which there was no or minimal external contribution. Using...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90110-b
更新日期：1990-01-01 00:00:00
abstract：:Cancer mortality from 1986 to 1992 was examined in a cohort of 4419 individuals who had been residing in an area of the municipality of Reggio Emilia, northern Italy, where tap water with unusually high selenium content was accidentally supplied. Mortality for all cancers was not significantly different, both in males...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(95)00014-u
更新日期：1995-09-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to develop an index derived from the Medication Appropriateness Index (MAI) items that is suited for clinical studies evaluating appropriateness of psychotropic drug use (PDU) for neuropsychiatric symptoms (NPS) in patients with dementia in nursing homes and to test its reliability ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.03.012
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:Surrogate markers are often used in clinical trials if too much time or expense is involved to observe the effect of treatment on patient-important outcomes. We wished to estimate the ultimate effects of treatment when randomized trials have addressed only a surrogate marker, and additional, independent studi...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2012.02.012
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVES:N-of-1 trials can be aggregated to estimate population treatment effects using hierarchical Bayesian models. It is very important to report core items in hierarchical Bayesian analysis. In this study, we assessed reporting of items in hierarchical Bayesian analysis for aggregating N-of-1 trials to estimate p...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.02.023
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:Intervention Modeling Experiments (IMEs) are a way of developing and testing behavior change interventions before a trial. We aimed to test this methodology in a Web-based IME that replicated the trial component of an earlier, paper-based IME. STUDY DESIGN AND SETTING:Three-arm, Web-based randomized evaluat...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinepi.2016.07.008
更新日期：2016-12-01 00:00:00
abstract：OBJECTIVES:Disinvestment is critical for ensuring the long-term sustainability of health-care services. Key barriers to disinvestment are heterogeneity between research and clinical settings, absence of evidence of effectiveness of some health technologies, and exposure of patients and organizations to risks and poor o...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2013.08.014
更新日期：2014-02-01 00:00:00
abstract：:A small variability of exposure in a population, for example small variance in nutrient intake, limits the power of an epidemiologic study. McKeown-Eyssen and Thomas (J Chron Dis 1985; 38:559-568) have shown that by selecting a population with larger exposure variance vs one with smaller variance, the study sample siz...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(94)90190-2
更新日期：1994-08-01 00:00:00
abstract：:A summary performance measure comprised of a hierarchical balance task, a 4-meter walk, and five repetitive chair stands is increasingly being used as a predictor of independent living for older persons. The reliability and sensitivity to change of this summary performance measure have not been investigated, however. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(02)00436-5
更新日期：2002-09-01 00:00:00
abstract：:The objective of the study was to determine the sensitivity and specificity of the National Cholesterol Education Program (NCEP) guidelines in identifying at-risk individuals for hypercholesterolemia, using population-based data from the Manitoba Heart Health Survey (MHHS). The MHHS surveyed a representative sample of...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)90301-8
更新日期：1994-05-01 00:00:00
