Abstract：
OBJECTIVES:The objective of this study was to determine the applicability of utilizing the N-of-1 method for deprescribing trials in older adults. STUDY DESIGN AND SETTING:Systematic review of any human studies conducted in older adults (≥50 years), deprescribing any long-term treatment over less than a year using the N-of-1 trial method was performed. Two authors independently reviewed all articles for eligibility and extracted data. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quality assessment of trials was carried out using the Physiotherapy Evidence Database scale. RESULTS:Six studies were identified and extracted. Trials investigated the efficacy of pharmacological and non-pharmacological therapies for treating diseases. Four trials demonstrated non-significant benefits of treatment, with a significant number of patients discontinuing their medications in two trials where follow-up data was collected (N = 8/18, 9/14 [44.4--64.3%]). In two studies, where treatment was beneficial, all participants were found to be maintaining regimen at follow-up. CONCLUSION:The N-of-1 trial methodology can be used to generate patient-specific evidence of medication and inform prescribing decisions. Future studies are required to assess the feasibility of using the N-of-1 method to determine the effects of deprescribing medications on short-term outcomes.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Clough AJ,Hilmer SN,Naismith SL,Kardell LD,Gnjidic Ddoi
10.1016/j.jclinepi.2017.09.015subject
Has Abstractpub_date
2018-01-01 00:00:00pages
112-119eissn
0895-4356issn
1878-5921pii
S0895-4356(17)30096-3journal_volume
93pub_type
杂志文章,评审abstract：:The association of non-insulin-dependent diabetes mellitus and disability was evaluated in a population of Mexican Americans from the southwest U.S. using data from the Hispanic Health and Nutrition Examination Survey. Among the total sample of persons who completed a clinical examination, 14.6% reported a limitation ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90101-r
更新日期：1992-05-01 00:00:00
abstract：OBJECTIVE:To estimate the effect of weight-loss interventions on health-related quality of life (HrQoL) in randomized controlled trials (RCTs); to conduct a meta-analysis of weight-loss treatment on depressive symptoms; and, to examine methodological and presentation issues that compromise study validity. STUDY DESIGN...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jclinepi.2004.10.015
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:A large number of trials remain difficult to locate or unpublished for systematic reviews. The objective of this article was to determine the usefulness of making e-mail contact with authors of clinical trials and literature reviews found in MEDLINE to identify unpublished or difficult to locat...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2005.11.022
更新日期：2006-07-01 00:00:00
abstract：:Efficient use of cholesterol measurements to screen for coronary heart disease in the elderly is not well defined. The purpose of this report is to examine such screening based on national guidelines in a sample of older men. Since relations between cholesterol and coronary heart disease are better established in thos...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(99)00130-4
更新日期：1999-12-01 00:00:00
abstract：:Although routinely used in health surveys, the factors affecting maternal perceptions of health in children, especially those with health problems, have received little examination. This question has been addressed using a telephone interview of families of 483 children followed in one of three clinics at Children's H...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(88)90139-4
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:In the course of performing systematic reviews on the prevalence of low back and neck pain, we required a tool to assess the risk of study bias. Our objectives were to (1) modify an existing checklist and (2) test the final tool for interrater agreement. STUDY DESIGN AND SETTING:The final tool consists of 10...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2011.11.014
更新日期：2012-09-01 00:00:00
abstract：:The traditional approach in epidemiology of relating exposure to an environmental agent such as a drug or infective agent has been to measure an overall risk (i.e., average and then "adjust risk for demographic variables and other confounders"). An attempt is sometimes made to define a "susceptible" subgroup. The anal...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00052-8
更新日期：1997-06-01 00:00:00
abstract：:This paper focuses on the appropriateness of outcome measures to evaluate trauma care. The preventable death rate (PDR), based on the study of deceased patients only, has been the traditional measure of the impact of trauma care on improving the survival of patients with severe trauma. Another measure frequently used ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90125-9
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：:We identified 38 case-control studies investigating possible associations between alcoholic beverage consumption and cancer of the female breast. Each study was characterized according to design features such as: control type (hospital or community based), risk factors controlled for, matching strategy, and statistica...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/0895-4356(94)90026-4
更新日期：1994-02-01 00:00:00
abstract：:Health researchers commonly use logistic regression when profiling health providers. Data from the patients treated by the providers are used to construct models predicting the expected number of outcomes for providers and the ratio of observed to expected outcomes (O/E ratio) used as a risk-adjusted measure of provid...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00048-9
更新日期：2003-06-01 00:00:00
abstract：:In 1984, a prospective cohort study, Coronary Artery Risk Development in Young Adults (CARDIA) was initiated to investigate life-style and other factors that influence, favorably and unfavorably, the evolution of coronary heart disease risk factors during young adulthood. After a year of planning and protocol developm...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(88)90080-7
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:To describe the pain decrease considered as clinically relevant when designing a trial and reporting its results. METHODS:A systematic review of the literature in MEDLINE was conducted to select randomized controlled trials (RCTs) with pain as a primary outcome. Data extracted included the definition (terms ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2010.06.008
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of applying a problem assessment versus a pure symptom urinary incontinence (UI) caseness definition in etiologic research. SUBJECTS:A random population sample of 2613 women aged 30-59 years, who responded to a postal questionnaire. MAIN PARAMETERS: One-year period prevalence of the...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00130-3
更新日期：1997-09-01 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：: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：:Time to revision is an important criterion describing the quality of implants in total joint surgery. Estimates of failure probabilities are required to inform a patient about the risk of suffering a reoperation. Also, regression models are used for comparing different prosthesis designs. Typically, patients dying bef...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(01)00371-7
更新日期：2001-10-01 00:00:00
abstract：OBJECTIVES:To compare the abilities of six validated comorbidity indices (Charlson index, cumulative illness rating scale [CIRS], index of coexistent diseases, Kaplan scale, geriatrics index of comorbidity [GIC], and chronic disease score) to predict adverse hospitalization outcomes (death during hospitalization, lengt...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2009.11.013
更新日期：2010-09-01 00:00:00
abstract：:Advances in laboratory techniques have led to a rapidly increasing use of biomarkers in epidemiological studies. Biomarkers of internal dose, early biological change susceptibility and clinical outcomes are used as proxies for investigating the interactions between external and/or endogenous agents and body components...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2011.07.010
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:For people with dementia, the concept of quality of life (Qol) reflects the disease's impact on the whole person. Thus, Qol is an increasingly used outcome measure in dementia research. This systematic review was performed to identify available dementia-specific Qol measurements and to assess the quality of l...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2015.08.002
更新日期：2016-02-01 00:00:00
abstract：OBJECTIVES:Procedures for controlling the false positive rate when performing many hypothesis tests are commonplace in health and medical studies. Such procedures, most notably the Bonferroni adjustment, suffer from the problem that error rate control cannot be localized to individual tests, and that these procedures d...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2014.03.012
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVES:Constructs capturing health or functioning can have reflective and/or formative measurement models. Although a construct's measurement model has extensive implications on the construction, validation, and use of a measurement instrument, measurement models are frequently wrongly or not explicitly specified. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2018.07.007
更新日期：2018-11-01 00:00:00
abstract：:We studied the outcome in 308 patients with acute myocardial infarction (MI) admitted to the coronary care unit of Kobe General Hospital. Short-term outcome (within 28 days after MI) and long-term outcome (more than 28 days) were examined with survival curves to find any relationship with a history of previous MI and ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90186-q
更新日期：1992-01-01 00:00:00
abstract：:A patient-administered instrument for dyspepsia and symptoms suggestive of duodenal or gastric ulcer, based on the type of questions asked when taking a patient's history, was developed and tested using the following steps: literature reviews, devising the questions, testing the responses to the questions using factor...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(95)00584-6
更新日期：1996-05-01 00:00:00
abstract：OBJECTIVES:Case-mix adjustment is difficult for stroke outcome studies using administrative data. However, relevant prescription, laboratory, procedure, and service claims might be surrogates for stroke severity. This study proposes a method for developing a stroke severity index (SSI) by using administrative data. ST...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.01.009
更新日期：2015-11-01 00:00:00
abstract：OBJECTIVES:The aim of the study was to describe the research environment of scientists in health services and policy research in China. STUDY DESIGN:Study was conducted during the 2016 Westlake Youth Forum with grantees of China Medical Board and key informants. Mixed methods used anonymous, survey of grantees, semist...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.05.004
更新日期：2019-08-01 00:00:00
abstract：:To compare Charlson indices based on chart data and ICD-9 data for agreement overall and on rating specific comorbid conditions, and to compare mortality risks associated with these indices. Prospective cohort study. Six general medicine wards at Yale-New Haven Hospital. 524 consecutive patients who had no clinical ev...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00367-x
更新日期：2001-07-01 00:00:00
abstract：:Criterion validity studies sometimes use designs with test-based enrollment schemes. In such incomplete studies, a Reference Instrument (RI) is applied to unequal sampling fractions of subjects previously identified as positives or negatives by a new Test Instrument (TI+ and TI-). Focusing on sensitivity (Se) and spec...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00162-8
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVES:Explicit reporting of absolute measures is important to ensure treatment effects are correctly interpreted. We examined the extent to which authors report absolute effects for patient-important outcomes in abstracts of systematic review (SR). STUDY DESIGN AND SETTING:We searched OVID MEDLINE and Cochrane Da...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.08.004
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:There is a pressing need for evidence-based interventions to address the devastating clinical and public health effects of the coronavirus disease 2019 (COVID-19) pandemic. The number of registered trials related to COVID-19 is increasing by the day. The objective of this study was to describe ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2020.06.005
更新日期：2020-09-01 00:00:00
