Abstract:
OBJECTIVES:Compared with controls, multiple sclerosis (MS) patients die, on average, 7-14 years prematurely. Previously, we reported that, 21 years after their participation in the pivotal randomised, controlled trial (RCT) of interferon β-1b, mortality was reduced by 46-47% in the two groups who received active therapy during the RCT. To determine whether the excessive deaths observed in placebo-treated patients was due to MS-related causes, we analysed the causes-of-death (CODs) in these three, randomised, patient cohorts. DESIGN:Long-term follow-up (LTF) of the pivotal RCT of interferon β-1b. SETTING:Eleven North American MS-centres participated. PARTICIPANTS:In the original RCT, 372 patients participated, of whom 366 (98.4%) were identified after a median of 21.1 years from RCT enrolment. INTERVENTIONS:Using multiple information sources, we attempted to establish COD and its relationship to MS in deceased patients. PRIMARY OUTCOME:An independent adjudication committee, masked to treatment assignment and using prespecified criteria, determined the likely CODs and their MS relationships. RESULTS:Among the 366 MS patients included in this LTF study, 81 deaths were recorded. Mean age-at-death was 51.7 (±8.7) years. COD, MS relationship, or both were determined for 88% of deaths (71/81). Patients were assigned to one of nine COD categories: cardiovascular disease/stroke; cancer; pulmonary infections; sepsis; accidents; suicide; death due to MS; other known CODs; and unknown COD. Of the 69 patients for whom information on the relationship of death to MS was available, 78.3% (54/69) were adjudicated to be MS related. Patients randomised to receive placebo during the RCT (compared with patients receiving active treatment) experienced an excessive number of MS-related deaths. CONCLUSIONS:In this long-term, randomised, cohort study, MS patients receiving placebo during the RCT experienced greater all-cause mortality compared to those on active treatment. The excessive mortality in the original placebo group was largely from MS-related causes, especially, MS-related pulmonary infections.
journal_name
BMJ Openjournal_title
BMJ openauthors
Goodin DS,Ebers GC,Cutter G,Cook SD,O'Donnell T,Reder AT,Kremenchutzky M,Oger J,Rametta M,Beckmann K,Knappertz Vdoi
10.1136/bmjopen-2012-001972subject
Has Abstractpub_date
2012-11-30 00:00:00issue
6issn
2044-6055pii
bmjopen-2012-001972journal_volume
2pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:To test agreement of two methods to measure intraocular pressure (IOP): rebound tonometry (RBT) and gold standard Goldmann applanation tonometry (GAT) in children with glaucoma. DESIGN:Observational prospective cohort study. SETTING:Tertiary paediatric glaucoma clinic at a single centre. PARTICIPANTS:102 i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001788
更新日期:2013-04-02 00:00:00
abstract:INTRODUCTION:Hearing loss is a common chronic problem which can be effectively managed with hearing devices. At present, only a limited number of people with hearing loss use hearing aids (HAs) and cochlear implants (CIs) to improve hearing and sound quality and enhance quality of life. Clinical equipoise, by which we ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030100
更新日期:2019-09-08 00:00:00
abstract:OBJECTIVES:(1) Investigate and explore whether different classes of associative stigma (the process by which a person experiences stigmatisation as a result of an association with another stigmatised person) could be identified using latent class analysis; (2) determine the sociodemographic and employment-related corre...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028179
更新日期:2019-07-11 00:00:00
abstract:OBJECTIVE:To explore how three indicators of social capital (ie, group membership, social support and cognitive social capital and specific types within each type) are associated with infant birth weight. STUDY DESIGN AND SETTINGS:Cross-sectional analyses of the first wave of Young Lives Survey data collected in 2002 ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024769
更新日期:2019-10-09 00:00:00
abstract:BACKGROUND:Migration is a major global driver of population change. Certain migrants may be at increased risk of infectious diseases, including tuberculosis (TB), HIV, hepatitis B and hepatitis C, and have poorer outcomes. Early diagnosis and management of these infections can reduce morbidity, mortality and onward tra...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029188
更新日期:2019-03-07 00:00:00
abstract:OBJECTIVE:Our cross-sectional study aimed at evaluating the diagnostic performance of Focused Assessment with Sonography for HIV-associated tuberculosis (FASH) to detect extrapulmonary tuberculosis in extremely resource-limited settings, with visceral leishmaniasis as a differential diagnosis with overlapping sonograph...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027179
更新日期:2019-04-02 00:00:00
abstract:OBJECTIVE:The proper use of safety measures by welders is an important way of preventing and/or reducing a variety of health hazards that they are exposed to during welding. There is a lack of knowledge about hazards and personal protective equipments (PPEs) and the use of PPE among the welders in Nepal is limited. We ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-004646
更新日期:2014-06-02 00:00:00
abstract:OBJECTIVES:To determine whether a polymorphism in the Fcγ receptor type IIIA (FCGR3A-F158V), influencing immunoglobulin G binding affinity, relates to the therapeutic efficacy of rituximab in rheumatoid arthritis (RA) patients. DESIGN:Observational cohort study. SETTING:Three university hospital rheumatology units in...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001524
更新日期:2012-09-22 00:00:00
abstract:INTRODUCTION:Owing to the high and increasing morbidity and mortality, chronic obstructive pulmonary disease (COPD) has become a major public health problem worldwide. Although the majority of patients with COPD are in the early stages, little attention has been paid to them, in particular regarding to early interventi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2013-003991
更新日期:2014-02-18 00:00:00
abstract:OBJECTIVES:To analyse the association of sedentary behaviour patterns with dietary and lifestyle habits among public school teachers. DESIGN:Cross-sectional study. PARTICIPANTS:A sample of 245 teachers (186 women and 59 men) with mean age of 45.2 (±10.4) were randomly selected from public schools. PRIMARY AND SECOND...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034322
更新日期:2020-01-23 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of and associations between anxiety, depression, post-traumatic stress disorder (PTSD), low subjective well-being (SWB), potential traumas and postmigration stress among refugees from Syria resettled in Sweden. DESIGN:A cross-sectional and population-based questionnaire study base...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-018899
更新日期:2017-12-29 00:00:00
abstract:OBJECTIVES:South Africa has achieved significant success with its tobacco control policy. Between 1994 and 2012, the real price of cigarettes increased by 229%, while regular smoking prevalence decreased from about 31% to 18.2%. METHODS:Cigarette prices and socioeconomic variables are used to examine the determinants ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011076
更新日期:2016-07-18 00:00:00
abstract:OBJECTIVES:To compare cardiovascular fitness and physical activity of schoolchildren 18 months after London 2012 according to Olympic 'inspiration'. DESIGN:A cross-sectional comparison between groups of schoolchildren categorised according to self-reported Olympic inspiration and a repeated cross-sectional comparison ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2016-011670
更新日期:2016-11-23 00:00:00
abstract:OBJECTIVE:The International Agency for Research on Cancer classifies hexavalent chromium (Cr(VI)) as a human carcinogen. As reported, cancer mortality was higher in Cr(VI)-contaminated areas. Scientists have recommended studying its health impact on people living in contaminated areas. This study aims to evaluate the h...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-021470
更新日期:2018-06-27 00:00:00
abstract::Objectives (1) To assess endorsement of trial registration in author instructions of urology-related journals and (2) to assess whether randomised controlled trials (RCTs) in the field of urology were effectively registered. Design Cross-sectional study of author instructions and published trials. Setting Journals p...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000430
更新日期:2011-12-06 00:00:00
abstract:INTRODUCTION:Neurological injury remains the major cause of morbidity and mortality following open aortic arch repair. Systemic hypothermia along with antegrade cerebral perfusion (ACP) is the accepted cerebral protection approach, with axillary artery cannulation being the most common technique used to establish ACP. ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2016-014491
更新日期:2017-06-10 00:00:00
abstract:INTRODUCTION:Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening illness of unknown aetiology, with no proven pharmacological treatments. There is a limited evidence base indicating that the disease negatively affects quality of life, leading to increased dependence, restrictions on daily activities ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003537
更新日期:2013-08-07 00:00:00
abstract:OBJECTIVE:The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-016077
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:Hip fracture patients of 65 years and older are a complex patient group who often suffer from complications and difficult rehabilitation with disappointing results. It is unknown to what extent suboptimal hospital care contributes to these poor outcomes. This study reports on the scale, preventability, cause...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006663
更新日期:2015-09-07 00:00:00
abstract:BACKGROUND:Research on patient safety in emergency medical services (EMS) has mainly focused on the organisation's and/or the EMS personnel's perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients' experiences of their sense of safety in EMS. METHODS:A qualitat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037488
更新日期:2020-10-21 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the current work distribution of health professionals from a public Ugandan medical school in a period of major donor funding for HIV programmes. We explore the hypothesis that programmes initiated under unprecedented health investments from the US President's Emerge...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002875
更新日期:2013-05-31 00:00:00
abstract:OBJECTIVES:The objectives of this study were to describe the methods used to assess the quality of linkage between records of babies' birth registration and hospital birth records, and to evaluate the potential bias that may be introduced because of these methods. DESIGN/SETTING:Data from the civil registration and th...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037885
更新日期:2020-10-26 00:00:00
abstract:OBJECTIVES:This study aimed to determine the seroprevalence of Toxoplasma gondii (T. gondii) infection in pregnant women in Matehuala City, Mexico; and the associated risk factors. DESIGN:A cross-sectional study. SETTING:Matehuala City, Mexico. PARTICIPANTS:311 pregnant women. PRIMARY AND SECONDARY OUTCOME MEASURES...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033995
更新日期:2020-08-06 00:00:00
abstract:INTRODUCTION:One in four diabetes patients will develop a foot ulcer over their lifetime. The role of glycaemic control in the healing of foot ulcers in diabetes patients is not supported by randomised controlled trial (RCT) data. OBJECTIVES:To determine the feasibility of an RCT of glycaemic control with intensive in...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029009
更新日期:2020-01-20 00:00:00
abstract:OBJECTIVES:(1) To examine the psychometric properties of the Basic Empathy Scale (BES) with Spanish adolescents, comparing a two and a three-dimensional structure;(2) To analyse the relationship between the three-dimensional empathy and social and normative adjustment in school. DESIGN:Transversal and ex post facto re...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015347
更新日期:2017-09-25 00:00:00
abstract:OBJECTIVES:Patient-centred care is related to better health outcomes, greater patient satisfaction and reduced healthcare costs. One of the core components of patient-centred care, defined in the patient-centred clinical method, is enhancing the patient-doctor relationship. In this study, we aim to measure the therapeu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033710
更新日期:2020-02-05 00:00:00
abstract:OBJECTIVE:To develop a novel sex independent anthropometric index, termed as angle index, related to type 2 diabetes. DESIGN:Case-control. PARTICIPANTS:The study comprised 121 participants and were divided into two groups. One group had no form of diabetes and served as controls (n=50). The other group had the condit...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024029
更新日期:2019-02-19 00:00:00
abstract:OBJECTIVE:To assess differences in weight status and movement behaviour guideline compliance among children aged 5-12 years with and without a family history of non-communicable diseases (NCDs). DESIGN:Prospective. SETTING AND PARTICIPANTS:Women born between 1973 and 1978 were recruited to the Australian Longitudinal...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038789
更新日期:2020-11-03 00:00:00
abstract:OBJECTIVES:French authorities are considering the implementation of a simplified nutrition labelling system on food products to help consumers make healthier food choices. One of the most documented candidates (Five-Colour Nutrition Label/Nutri-score) is based on the British Food Standards Agency Nutrient Profiling Sys...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013718
更新日期:2017-06-08 00:00:00
abstract:OBJECTIVES:To investigate the variation in sugar and energy content of cakes and biscuits available in the UK. DESIGN:We carried out a cross-sectional survey in 2016 of 381 cakes and 481 biscuits available in nine main UK supermarkets. METHODS:The sugar and energy content was collected from product packaging and nutr...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019075
更新日期:2018-07-25 00:00:00