Abstract:
OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers. INTERVENTIONS:Usual care provided by memory clinic or general practitioner. MAIN OUTCOME MEASURES:Caregiver rated quality of life of the patient measured with the quality of life in Alzheimer's disease instrument and self perceived burden of the informal caregiver measured with the sense of competence questionnaire (intention to treat analysis). RESULTS:The quality of life of the patients in the memory clinic group was 0.5 (95% confidence interval -0.7 to 1.6) points higher than in the general practitioner group. Caregivers' burden was 2.4 (-5.8 to 1.0) points lower in the memory clinic group than in the general practitioner group. CONCLUSION:No evidence was found that memory clinics were more effective than general practitioners with regard to post-diagnosis treatment and coordination care for patients with dementia. Without further evidence on the effectiveness of these modalities, other arguments, such as cost minimisation, patients' preferences, or regional health service planning, can determine which type of dementia care is offered. TRIAL REGISTRATION:Clinical trials NCT00554047.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Meeuwsen EJ,Melis RJ,Van Der Aa GC,Golüke-Willemse GA,De Leest BJ,Van Raak FH,Schölzel-Dorenbos CJ,Verheijen DC,Verhey FR,Visser MC,Wolfs CA,Adang EM,Olde Rikkert MGdoi
10.1136/bmj.e3086subject
Has Abstractpub_date
2012-05-15 00:00:00pages
e3086eissn
0959-8138issn
1756-1833journal_volume
344pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:To study the role of respiratory viruses in exacerbations of asthma in adults. DESIGN:Longitudinal study of 138 adults with asthma. SETTING:Leicestershire Health Authority. SUBJECTS:48 men and 90 women 19-46 years of age with a mean duration of wheeze of 19.6 years. 75% received regular treatment with bron...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:1993-10-16 00:00:00
abstract:OBJECTIVE:To assess whether occupational exposure among commercial airline cabin attendants are associated with risk of cancer. DESIGN:Record linkage study. SETTING:Finland. SUBJECTS-1577 female and 187 male cabin attendants who had worked for the Finnish airline companies. MAIN OUTCOME MEASURE:Standardised incidenc...
journal_title:BMJ (Clinical research ed.)
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更新日期:1995-09-09 00:00:00
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
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更新日期:2010-12-14 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.)
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abstract:OBJECTIVE:To determine the relative contribution of decline in bone density to the increase in risk of hip fracture with age in men and women. DESIGN:Incidence data of hip fracture from the general population were combined with the bone density distribution in a sample from the same population and with a risk estimate...
journal_title:BMJ (Clinical research ed.)
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更新日期:1997-07-26 00:00:00
abstract:OBJECTIVES:To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. DESIGN:Double masked, randomised placebo controlled trial. SETTING:A slum community in New Delhi, India. PARTICIPANTS:2482 children aged 6 to 30 months. INTERVENTIO...
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更新日期:1998-12-12 00:00:00
abstract:OBJECTIVES:To measure the prevalence of domestic violence among women attending general practice; test the association between experience of domestic violence and demographic factors; evaluate the extent of recording of domestic violence in records held by general practices; and assess acceptability to women of screeni...
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更新日期:2002-02-02 00:00:00
abstract:OBJECTIVE:To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. DESIGN:Prospective, operator blinded, randomised controlled trial. SETTING:General dental practice, London. PARTICIPANTS:100 adult smokers...
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更新日期:2005-10-29 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:1989-04-15 00:00:00
abstract:OBJECTIVE:To examine the absolute risks or benefits on cancer associated with oral contraception, using incident data. DESIGN:Inception cohort study. SETTING:Royal College of General Practitioners' oral contraception study. PARTICIPANTS:Directly standardised data from the Royal College of General Practitioners' oral...
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39289.649410.55
更新日期:2007-09-29 00:00:00
abstract::In July 1992 Dr Keith Mumby, a clinical ecologist, appeared before the professional conduct committee of the General Medical Council on five charges to do with his practice of clinical ecology. He was found guilty of two of the charges--touting for publicity and failing to give a patient adequate medical attention--an...
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pub_type: 杂志文章
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更新日期:1993-01-09 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2013-07-12 00:00:00
abstract:OBJECTIVE:To investigate whether users of oral contraceptives and in [corrected] carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis. DESIGN:Comparison of a prospective series of cases of cerebral sinu...
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更新日期:1998-02-21 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
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更新日期:2018-03-05 00:00:00
abstract:OBJECTIVE:To confirm the findings of pilot studies that interferon alfa is an effective treatment of Europid men with chronic hepatitis B virus infection. DESIGN:Randomised controlled trial of three months treatment with interferon alfa followed by 12 months of observation. SETTING:Outpatient clinic of a tertiary ref...
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.299.6700.652
更新日期:1989-09-09 00:00:00
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doi:10.1136/bmj.300.6720.300
更新日期:1990-02-03 00:00:00
abstract:OBJECTIVE:To assess the performance and impact of a two tier neonatal screening programme for cystic fibrosis based on an initial estimation of immunoreactive trypsinogen followed by direct gene analysis. DESIGN:Four year prospective study of two tier screening strategy. First tier: immunoreactive trypsinogen measured...
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更新日期:1994-06-04 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.a1302
更新日期:2008-09-02 00:00:00
abstract:BACKGROUND:Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalent...
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更新日期:2010-04-14 00:00:00
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更新日期:2010-12-21 00:00:00
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更新日期:2013-06-24 00:00:00
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更新日期:2005-06-18 00:00:00
abstract:OBJECTIVES: To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN: Observational cohort study. SETTING: US Health and Retirement Study. PARTICIPANTS: 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage w...
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更新日期:2016-05-17 00:00:00
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更新日期:2012-10-31 00:00:00
abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...
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.322.7295.1154
更新日期:2001-05-12 00:00:00
abstract:OBJECTIVE:To evaluate the safety of withholding anticoagulant treatment from patients with clinically suspected deep vein thrombosis but normal findings on compression ultrasonography. DESIGN:Compression ultrasonography was done with a simplified diagnostic procedure limited to the common femoral vein in the groin and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.316.7124.17
更新日期:1998-01-03 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.i1351
更新日期:2016-03-29 00:00:00