Abstract:
:Although previous studies document that blood pressure measured in the clinic may differ significantly from blood pressure recorded over 24 hours, the impact of these differences on patient selection for therapeutic drug trials is unknown. A placebo controlled double-blind evaluation of an experimental antihypertensive agent was conducted. Of 30 patients entered, 21 were admitted to the active drug phase of the protocol on the basis of a clinic supine diastolic blood pressure greater than or equal to 95 mmHg; 9 subjects with lower levels of diastolic blood pressure were dropped. Noninvasive ambulatory blood pressure monitoring was performed during the placebo period. Comparison of the two subgroups demonstrated similar levels of 24 hour blood pressure (142 +/- 13/86 +/- 7 vs 137 +/- 10/82 +/- 10). Analysis of individual patient data showed that 24 hour mean diastolic blood pressure was apparently normal (less than or equal to 80 mmHg) in 5/21 (24%) "admitted" and 3/9 (33%) "dropped" subjects. Circadian blood pressure pattern were similar in the two subgroups. A statistically large difference was noted between clinic and 24 hour blood pressures in the "admitted" subgroup (20 +/- 18/13 +/- 7 vs 7 +/- 12/4 +/- 6, p less than 0.08/p less than 0.001), suggesting that patients exhibiting a marked blood pressure rise in the clinic setting were preferentially selected.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Gradman AH,Pangan P,Germain Mdoi
10.1016/0895-4356(89)90046-2subject
Has Abstractpub_date
1989-01-01 00:00:00pages
1049-54issue
11eissn
0895-4356issn
1878-5921pii
0895-4356(89)90046-2journal_volume
42pub_type
临床试验,杂志文章abstract:OBJECTIVES:To examine the validity of (1) maternal questionnaire report of children's use of antiasthmatics using a prescription database as the reference standard and (2) dispensed antiasthmatics as a measure of asthma using maternal report of children's asthma as the reference standard. STUDY DESIGN AND SETTING:A to...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2010.10.014
更新日期:2011-08-01 00:00:00
abstract::The uses of hypothesis in scientific medicine and in clinical medicine are broadly similar; but they differ in subtle but important logical details. The key distinction is that scientific medicine deals with broad ("public") hypotheses about entire populations; and the predominant problem of inference is statistics in...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(89)90028-0
更新日期:1989-01-01 00:00:00
abstract::This article (Part II) and the preceding article (Part I) report the development of two clinical staging systems for HIV-infected individuals. The objective of the research reported here (Part II) was to construct a clinical staging system to predict survival in patients with AIDS. We analyzed data from VA Cooperative...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(97)00182-0
更新日期:1997-11-01 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::Differences in the rate of metacarpal bone loss were evaluated in a 9 year population based follow-up study among 799 women initially aged 45-64 years, using initial and follow-up radiographs of the hands. Metacarpal bone loss started around the age of 50 years and was present in more than 95% of the women. The averag...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(90)90162-i
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:The Osteoarthritis Questionnaire (OA-Quest) is a new measure of individual burden of osteoarthritis, composing seven brief (4-11 items; total 42 items), independent scales. This study describes the psychometric evaluation of the OA-Quest. Specifically, temporal stability, convergent and discriminant validity...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.06.001
更新日期:2019-10-01 00:00:00
abstract::Many longitudinal studies attempt to examine changes in outcome measures over time in groups of patients. Applying conventional analytic techniques, such as a single classical linear regression model, to these data will often not result in minimum variance estimates, and may affect the results of tests of significance...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(93)90038-3
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:Our study aimed to systematically assess and report the methodological quality used in epidemiological systematic reviews (SRs) and meta-analysis (MA) of pathogen genotypes/genogroups. STUDY DESIGN AND SETTING:Nine electronic databases and manual search of reference lists were used to identify relevant stud...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2019.11.009
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:How often authors comment on applicability for primary care in systematic reviews of clinical trials. STUDY DESIGN AND SETTING:We selected 4% of the Cochrane Database for Systematic Reviews (CDSRs; January 2008 to October 2013). We excluded reviews when primary care trials were not eligible. We extracted wh...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.06.003
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.05.014
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Statistical interaction between a single, instantaneous exposure and attained age (age during follow-up; attained age = age at exposure + time since exposure) is used in risk analyses to assess potential effect modification by unmeasured factors correlated with age. However, the impact of such interaction on ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.10.004
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To assess whether nominally statistically significant effects in meta-analyses of clinical trials are true and whether their magnitude is inflated. STUDY DESIGN AND SETTING:Data from the Cochrane Database of Systematic Reviews 2005 (issue 4) and 2010 (issue 1) were used. We considered meta-analyses with bina...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.12.012
更新日期:2011-10-01 00:00:00
abstract::Mortality in relation to body mass index (BMI) was studied in 17,159 healthy Finnish women aged 25-79 followed up for a median of 12 years. Mortality from all cases was related to BMI only in non-smokers aged 25-64, among whom the mortality pattern was "U"-shaped, with a minimum in the second quintile of BMI (the refe...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90131-r
更新日期:1991-01-01 00:00:00
abstract::Studies of determinants of recurrent disease often give unexpected results. In particular, well-established risk factors may seem not to have much influence on the recurrence risk. Recently, it has been argued that such paradoxical findings may be because of the bias caused by the selection of patients based on the oc...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2012.06.023
更新日期:2013-02-01 00:00:00
abstract::Our objective was to describe distortion in outcome studies due to "frailty bias" or differential susceptibility to adverse health outcomes due to frailties but attributed to other factors. We linked an administrative database to survey data (n = 5934) containing functional, condition, and outcome measures. The diseas...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(99)00056-6
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Reference limits are widely used in anthropometry, the behavioral sciences, medicine, and clinical chemistry. They describe the distribution of a quantitative variable in a healthy population, and are often a smooth function of age or another determinant. Thus, instead of estimating reference l...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.09.004
更新日期:2007-06-01 00:00:00
abstract::Pragmatic trials aim to inform clinical decision making by measuring the effect of a treatment in clinical practice. The purpose of the PRECIS-2 tool is to support in designing a truly pragmatic trial. We comment on a study by Forbes et al., who assessed the applicability of the PRECIS-2 tool. The tool will prove part...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.06.006
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Two methods for measuring insulin sensitivity, fasting plasma insulin (FPI) and homeostasis model assessment (HOMA) have been proposed for use in large epidemiological research and clinical practice. This project describes the range of observed values of the HOMA and FPI in a large sample of th...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.05.001
更新日期:2004-11-01 00:00:00
abstract::Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90009-x
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hui and Walter developed a latent class approach to assess the accuracy of a diagnostic procedure when no reference test is available. Our objective was to compare sensitivity and specificity estimates obtained with this reference-free approach and standard approaches, and to examine how and wh...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.10.021
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVES:To revise 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions in systematic reviews produced by the Evidence-based Practice Center (EPC) program, established by the US Agency for Healthcare Research and Quality (AH...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.11.023
更新日期:2015-11-01 00:00:00
abstract::In replication of two recent studies, it was intended to show that headache symptoms obtained by means of questionnaires fit a categorial model, provided that appropriate methods of data analysis are used. In addition, the questions which are best posed to obtain a succinct classification should be determined. Configu...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)00182-p
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:It is difficult to compare the reliability of triage systems with the kappa statistic. In this article, a method for comparing triage systems was developed and applied to previously conducted triage reliability studies. STUDY DESIGN AND SETTING:From simulations with theoretical distributions, the minimum, n...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.01.012
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:This study evaluated search strategies for finding high-quality studies on treatment and systematic reviews in PsycINFO. STUDY DESIGN AND SETTING:Sixty-four journals were hand searched at McMaster University. Methodologic criteria were applied to clinically relevant articles to identify "pass" and "fail" art...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.09.016
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to identify factors affecting the use of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, specifically authors' attitudes toward and experiences with it. STUDY DESIGN AND SETTING:An online survey was distributed to authors of observa...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.07.019
更新日期:2019-12-01 00:00:00
abstract::To assess the accuracy of Bayesian probability analysis for the prediction of coronary artery disease, post-test probabilities were generated by the application of three Bayesian algorithms to the clinical and noninvasive test results of 199 patients undergoing angiography in a veterans' hospital. All assumed conditio...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(88)90065-0
更新日期:1988-01-01 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::The aim of this paper was to evaluate the combined effect of alcohol, smoking habits and frequency of consumption of selected dietary items, which are the major sources of retinoids and beta-carotene in the Italian diet, on the risk of esophageal cancer (EC). The adequacy of the multiplicative structure for describing...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90035-l
更新日期:1992-04-01 00:00:00
abstract::To effectively evaluate medical literature, practicing physicians and medical researchers must understand the impact of statistical tests on research outcomes. Applying inefficient statistics not only increases the need for resources, but more importantly increases the probability of committing a Type I or Type II err...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00168-1
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To compare methods commonly used to derive minimal important differences and recommend a rule for defining patients as clinically improved on the low back pain-specific Roland-Morris Disability Questionnaire (RMDQ). METHODS:447 primary care low back pain consulters completed a questionnaire at consultation a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.03.018
更新日期:2006-01-01 00:00:00