Abstract:
OBJECTIVES:To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations. DESIGN:Cross sectional screening programme. SETTING:Six general practices in Oxfordshire. PATIENTS:1901 Men and 2068 women aged 25-59. MAIN OUTCOME MEASURE:Cardiovascular risk as assessed by fasting venous plasma concentrations of total cholesterol, triglyceride, and HDL cholesterol. RESULTS:2931 Patients (74% of those screened) had a total cholesterol concentration of less than 6.5 mmol/l. If the triglyceride concentration had not been measured in these patients isolated hypertriglyceridaemia (greater than or equal to 2.3 mmol/l) would have remained undetected in 185. Among these 185 patients, however, 123 were overweight or obese and only 18 (0.6% of those screened) had an increased risk associated with both a raised triglyceride concentration (greater than or equal to 2.3 mmol/l) and a low HDL cholesterol concentration (less than 0.9 mmol/l). Conversely, in the 790 patients with predominant hypercholesterolaemia (cholesterol concentration greater than or equal to 6.5 mmol/l and triglyceride concentration less than 2.3 mmol/l) measurement of HDL cholesterol concentration showed that 348 (9% of those screened) had only a moderately increased risk with a ratio of total to HDL cholesterol of less than 4.5 and 104 had a low risk with a ratio of less than 3.5. CONCLUSIONS:Fasting triglyceride and HDL cholesterol concentrations identify few patients at increased risk of coronary heart disease if the total cholesterol concentration is less than 6.5 mmol/l. HDL cholesterol and triglyceride concentrations should, however, be measured in patients with a total cholesterol concentration exceeding this value. Total cholesterol concentration alone may overestimate risk in a considerable number of these patients, and measurement of HDL cholesterol concentration allows a more precise estimate of risk. Measurement of the triglyceride concentration is required to characterise the lipoprotein abnormality. A patient should not be started on a drug that lowers lipid concentrations without having had a full lipoprotein assessment including measurement of HDL cholesterol concentration.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Neil HA,Mant D,Jones L,Morgan B,Mann JIdoi
10.1136/bmj.301.6752.584subject
Has Abstractpub_date
1990-09-22 00:00:00pages
584-7issue
6752eissn
0959-8138issn
1756-1833journal_volume
301pub_type
杂志文章abstract:OBJECTIVES:To prospectively assess the diagnostic performance of simple ultrasound rules to predict benignity/malignancy in an adnexal mass and to test the performance of the risk of malignancy index, two logistic regression models, and subjective assessment of ultrasonic findings by an experienced ultrasound examiner ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c6839
更新日期:2010-12-14 00:00:00
abstract:OBJECTIVE:To assess the association between mind wandering (thinking unrelated to the task at hand) and the risk of being responsible for a motor vehicle crash. DESIGN:Responsibility case-control study. SETTING:Adult emergency department of a university hospital in France, April 2010 to August 2011. PARTICIPANTS:955...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8105
更新日期:2012-12-13 00:00:00
abstract:OBJECTIVES:To examine the association between income inequality and the risk of mortality and readmission within 30 days of hospitalization. DESIGN:Retrospective cohort study of Medicare beneficiaries in the United States. Hierarchical, logistic regression models were developed to estimate the association between inco...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f521
更新日期:2013-02-14 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of manipulative therapy, physiotherapy, treatment by the general practitioner, and placebo therapy in patients with persistent non-specific back and neck complaints. DESIGN:Randomised clinical trial. SETTING:Primary health care in the Netherlands. PATIENTS:256 patients with non...
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.304.6827.601
更新日期:1992-03-07 00:00:00
abstract::The opportunities for international public health collaboration through joint business ventures between the USSR and Western nations, an arrangement that would benefit the public, industry, and the medical community, are discussed. Evidence indicates that the state of health of the Soviet population is declining rapi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6777.633
更新日期:1991-03-16 00:00:00
abstract:OBJECTIVE:To determine whether a booklet given to patients being discharged from hospital giving details of their admission and treatment increased their knowledge and recall when reviewed in outpatient clinics. DESIGN:Patients alternately allocated to receive a booklet or to serve as controls. Assessment by a questio...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6677.870
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To identify and explore parents' concerns when young children become acutely ill. DESIGN:Qualitative study making use of semi-structured one to one and group interviews with parents of preschool children. SETTING:Disadvantaged inner city community. SUBJECTS:95 parents of preschool children. RESULTS:Fever,...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7063.983
更新日期:1996-10-19 00:00:00
abstract::Molecular techniques have revolutionised our knowledge of cell and tissue function in both health and disease. We already have new and powerful treatments based on an understanding of communication between cells by messenger molecules called cytokines. Furthermore, there is great therapeutic promise in defining molecu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.314.7075.203
更新日期:1997-01-18 00:00:00
abstract:OBJECTIVE:To determine if sufficient evidence exists to support the use of magnetic resonance angiography as a means of selecting patients with recently symptomatic high grade carotid stenosis for surgery. DESIGN:Systematic review of published research on the diagnostic performance of magnetic resonance angiography, 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.324.7331.198
更新日期:2002-01-26 00:00:00
abstract:OBJECTIVES:To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweete...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3576
更新日期:2015-07-21 00:00:00
abstract:OBJECTIVES:To assess the feasibility and effectiveness of a general practice based, proactive system of asthma care in children. DESIGN:Randomised controlled trial with cluster sampling by general practice. SETTING:General practices in the northern region of the Australian Capital Territory. PARTICIPANTS:174 childre...
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.327.7416.659
更新日期:2003-09-20 00:00:00
abstract:OBJECTIVE:To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN:Cluster randomised controlled trial over 20 weeks. SETTING:Family compou...
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.38512.618681.E0
更新日期:2005-09-03 00:00:00
abstract:STUDY QUESTION:What are the long term trends in the total (live births, fetal deaths, and terminations of pregnancy for fetal anomaly) and live birth prevalence of neural tube defects (NTD) in Europe, where many countries have issued recommendations for folic acid supplementation but a policy for mandatory folic acid f...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h5949
更新日期:2015-11-24 00:00:00
abstract:OBJECTIVE:To investigate the association between birth weight of offspring and mortality among fathers and mothers in the west of Scotland. DESIGN:Prospective observational study. PARTICIPANTS:794 married couples in Renfrew district of the west of Scotland. MAIN OUTCOME MEASURES:Mortality from all causes and from ca...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7117.1189
更新日期:1997-11-08 00:00:00
abstract::The author is one of the medical advisers to the judge who led a government inquiry into allegations that an experimental research program at the National Women's Hospital in Auckland, New Zealand, to study the natural course of cervical carcinoma in situ had withheld conventional treatment from some patients. She ar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6647.533
更新日期:1988-08-20 00:00:00
abstract::National allocation of resources to regional health authorities and by them to districts is now determined by a weighted capitation formula. The national formula was derived from regression analysis, with hospital utilisation as an index of need for health care--a method which has fundamental limitations. This paper a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6881.835
更新日期:1993-03-27 00:00:00
abstract:OBJECTIVE:To assess relative efficacy and toxicity of aminoglycosides given by single daily dose compared with multiple daily doses. DESIGN:Meta-analysis of 21 randomised trials identified through MEDLARS (1966 to January 1995). Data were overviewed with fixed effects and random effects models and with meta-regression...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.312.7027.338
更新日期:1996-02-10 00:00:00
abstract:OBJECTIVE:To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays. DESIGN:Retrospective database study. SETTING:Palliative care unit in Germany. POPULATION:All admissions to palliative care unit between 1 January 1997 and 31 December 2008. MAIN OUTCOM...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7370
更新日期:2014-12-16 00:00:00
abstract:OBJECTIVE:To determine whether elderly people can learn to use the inhaler used to deliver zanamivir (Relenza Diskhaler) as effectively as the Turbohaler and to identify which aspects of inhaler technique are most problematic. DESIGN:Randomised, controlled, intervention study. SETTING:Wards for acute elderly care in ...
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.322.7286.577
更新日期:2001-03-10 00:00:00
abstract:OBJECTIVE:To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. DESIGN:Multicentre retrospective case-control study. SETTING:79 emergency departments of hospitals associated with the Pediatric Emergency...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f4836
更新日期:2013-08-12 00:00:00
abstract:OBJECTIVE:To assess the associations between different antidepressant treatments and the rates of suicide and attempted suicide or self harm in people with depression. DESIGN:Cohort study. SETTING:Patients registered with UK general practices contributing data to the QResearch database. PARTICIPANTS:238,963 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h517
更新日期:2015-02-18 00:00:00
abstract:OBJECTIVE:To investigate the intrinsic effects of individually prescribed homoeopathic medicines. DESIGN:Randomised double blind placebo controlled study. SETTING:Paediatric outpatient department of university hospital. PATIENTS:175 children with frequently recurring upper respiratory tract infections. Of the 170 ch...
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.309.6965.1329
更新日期:1994-11-19 00:00:00
abstract::An association between vasectomy and the development of testicular tumors, and the importance of testicular examinations both before and after a vasectomy is discussed. Patients diagnosed with testicular tumors within the last ten years were examined at Bangour General Hospital in Scotland. From 1977-87, 37 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6721.370
更新日期:1990-02-10 00:00:00
abstract::London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6871.199
更新日期:1993-01-16 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of emotionalism after stroke, to assess its relation with other mood disorders, and to identify clinical variables with which it is associated. DESIGN:Descriptive study of a cohort of patients consecutively entered on a community stroke register. SETTING:Community based research p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6679.991
更新日期:1989-04-15 00:00:00
abstract:OBJECTIVE:To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). DESIGN:Follow up study of 3 months. SETTING:Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7214.878
更新日期:1999-10-02 00:00:00
abstract:OBJECTIVE:To appraise a new method of prenatal screening for Down's syndrome based on maternal serum concentrations of alpha fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin combined with maternal age--the "triple test." DESIGN:Examination of the cost effectiveness of the triple test relative to s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6785.1133
更新日期:1991-05-11 00:00:00
abstract::The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.l5456
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between migraine and cognitive decline among women. DESIGN:Prospective cohort study. SETTING:Women's Health Study, United States. PARTICIPANTS:6349 women aged 65 or older enrolled in the Women's Health Study who provided information about migraine status at baseline and particip...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5027
更新日期:2012-08-08 00:00:00
abstract:OBJECTIVE:To assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments. DESIGN:Prospective study over six weeks. SETTING:Teaching hospital casualty x ray department. PATIENTS:3394 consecutive patients referred for radiography. INTERVENTIONS:Radiogr...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.302.6776.568
更新日期:1991-03-09 00:00:00