Abstract:
:Medicine has been dominated by uncontrolled data, often of unproven validity and insufficient to answer clinically important questions pertaining to individual patients. Controlled clinical trials, when designed and conducted rigorously, offer advantages over uncontrolled data, but they cannot be done for everything and often cater to the interests of sponsors rather than medical knowledge. With such sparse evidence, clinical research is doomed to look at main effects across populations rather than diversity of effects among individuals. By accumulating data from a large number of studies, meta-analysis provides a unique opportunity to address individual- and study-level heterogeneity. Diversity may be due to biases or may be real. Both sources must be scrutinized and meta-analysis may find a prime role in dissecting these components of diversity. Concurrent progress in basic sciences revolutionizing our predictive power for disease outcomes will heighten the importance of considering individual heterogeneity.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Ioannidis JP,Lau Jdoi
10.1016/s0895-4356(98)00042-0subject
Has Abstractpub_date
1998-08-01 00:00:00pages
709-11issue
8eissn
0895-4356issn
1878-5921pii
S0895-4356(98)00042-0journal_volume
51pub_type
杂志文章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:A comprehensive picture of population health status can be captured by the incorporation of patient-reported outcome measures into population health monitoring. OBJECTIVE:The aim of the study was to identify the current state, opportunities, and future research related to the utilization of patient-reported...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.04.018
更新日期:2017-09-01 00:00:00
abstract::This study investigates aspects of the reliability of the Maastricht criteria list for quality assessment in systematic reviews, and whether blinded reviewing is necessary to prevent review bias. We used the data set of 12 articles from a systematic review concerning the efficacy of balneotherapy in patients with arth...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(97)00297-7
更新日期:1998-04-01 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::This review critically appraises 22 recent articles of trials of physical activity, as a means of reducing blood pressure. The quality of the literature remains poor and of the 13 controlled trials of habitual activity only one did not have a major design fault. Overall, blood pressure was reduced by physical activity...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/0895-4356(92)90093-3
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:To study whether the methodological change from parent to index subject as questionnaire respondent affected the prevalence estimates and risk factor patterns for allergic diseases in a longitudinal study. STUDY DESIGN AND SETTING:A prospective study of asthma and allergic diseases among children was begun ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2009.08.017
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:We provide a case-cohort approach and show that a full competing risk analysis is feasible even in a reduced data set. Competing events for hospital-acquired infections are death or discharge from the hospital because they preclude the observation of such infections. STUDY DESIGN AND SETTING:Using surveilla...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2015.11.011
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Novel cancer therapies are often approved with evidence from a single pivotal trial alone. There are concerns about the credibility of this evidence. Higher validity may be indicated by five methodological and statistical characteristics of pivotal trial evidence that were described by the U.S....
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.05.033
更新日期:2019-10-01 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::Three issues concerning the design and analysis of randomized behavioral intervention studies are illustrated and discussed within the framework of a tobacco and alcohol prevention trial among migrant Latino adolescents. The first issue arises when subjects are randomized in clusters rather than individually. Because ...
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(03)00012-x
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Response bias may affect the result of surveys with <100% response rate. We applied methods commonly used in meta-analysis to ascertain the extent to which response bias affects multiwave survey results. METHODS:To test hypotheses of between-wave similarity, we used the Cochran-Armitage test f...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.11.027
更新日期:2005-08-01 00:00:00
abstract::Cross-sectional data from the Epidemiology of Diabetes Complications Study were used to examine the relationships between waist to hip circumference ratio (WHR) and the presence of diabetes complications in IDDM adults ages 18-45 years (N = 586). Significantly higher WHRs were observed among both genders with prolifer...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90291-7
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:To assess differences between three different decision-making approaches in the method of panel diagnosis as reference standard in diagnostic research. STUDY DESIGN AND SETTING:Within a diagnostic study, the prevalence of heart failure (HF) and chronic obstructive pulmonary disease (COPD) was compared using...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.09.020
更新日期:2015-04-01 00:00:00
abstract::The Indonesian Food and Drug Agency began to evaluate drug applications in the early 1970s through an Advisory Committee. This was in response to the perestroika-like policy applied to our drug industry; nowadays there are more than 300 drug companies formulating some 13,5600 drug products. During 1977-1988, 603 drugs...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(91)90111-l
更新日期:1991-01-01 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:BACKGROUND AND OBJECTIVES:The determinants of guideline panels' recommendations remain uncertain. The objective of this study was to investigate factors considered by members of 8 panels convened by the American Society of Hematology (ASH) to develop guidelines using Grading of Recommendations Assessment, Development, ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2019.02.009
更新日期:2019-06-01 00:00:00
abstract::Occasionally, the efficacy of screening for cancer recurrence has been evaluated by means of case-control studies. However, these studies generally have not been designed and analyzed in a manner that will yield an unbiased result. The commentary shows that by adhering to the principles developed for the analysis of s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2010.07.013
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Mendelian randomization is a popular technique for assessing and estimating the causal effects of risk factors. If genetic variants which are instrumental variables for a risk factor are shown to be additionally associated with a disease outcome, then the risk factor is a cause of the disease. However, in man...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.08.001
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate how often the European Medicines Agency (EMA) has authorized drugs based on nonrandomized studies and whether there is an association between treatment effects and EMA preference for further testing in randomized clinical trials (RCTs). STUDY DESIGN AND SETTING:We revie...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2018.01.011
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To present estimates of clinically meaningful or minimal important changes for the Oxford Hip Score (OHS) and the Oxford Knee Score (OKS) after joint replacement surgery. STUDY DESIGN AND SETTING:Secondary data analysis of the NHS patient-reported outcome measures data set that included 82,415 patients list...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.08.009
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:This study investigated trial consultations to identify whether and to what extent discussions of retention are present. STUDY DESIGN AND SETTING:This embedded mixed-methods study design included a purposive sample of audio-recorded trial consultations obtained from four sites of a large multicenter UK-base...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2020.03.011
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:We sought to examine the validity of specific hospital discharge codes in identifying drug toxicity precipitating hospitalization, among elderly users of high-risk medications. STUDY DESIGN AND SETTING:We conducted a cross-sectional evaluation assessing the diagnostic test characteristics of International Cl...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2007.08.003
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:The aim was to construct and validate algorithms for osteoporosis case ascertainment from administrative databases and to estimate the population prevalence of osteoporosis for these algorithms. STUDY DESIGN AND SETTING:Artificial neural networks, classification trees, and logistic regression were applied t...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2008.02.002
更新日期:2008-12-01 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:This study tested the impact of web administration on well-established measures of children's physical function and quality of life. STUDY DESIGN AND SETTING:Participants were recruited from clinics at six hospitals. They completed the Activities Scale for Kids (ASK) and the Pediatric Quality of Life Invento...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2008.06.011
更新日期:2009-03-01 00:00:00
abstract::Measuring the effectiveness of cognitive rehabilitation programs poses both conceptual and practical challenges. We compared several standardized outcome measures with goal attainment scaling (GAS) to assess their sensitivity to changes in health status in patients undergoing cognitive rehabilitation. GAS is a measure...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(97)00014-0
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Treatments may be more effective in some patients than others, and individual participant data (IPD) meta-analysis of randomized trials provides perhaps the best method of investigating treatment-covariate interactions. Various methods are used; we provide a comprehensive critique and develop guidance on meth...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.11.016
更新日期:2011-09-01 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:Hypertension is a risk factor for aortic dissection. Besides hypertension, associated factors for incidence of aortic dissection are not clear. The aim of this study was to examine whether other factors exist by an epidemiologic case-control approach. STUDY DESIGN AND SETTING:240 consecutive cases suffering ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2003.09.010
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. STUDY DESIGN AND SETTING:An overview of reporting guidelines for qualitative, implem...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.10.022
更新日期:2018-05-01 00:00:00