Abstract:
OBJECTIVE:To quantify an association between acute kidney injury and use of high potency statins versus low potency statins. DESIGN:Retrospective observational analysis of administrative databases, using nine population based cohort studies and meta-analysis. We performed as treated analyses in each database with a nested case-control design. Rate ratios for different durations of current and past statin exposure to high potency or low potency statins were estimated using conditional logistic regression. Ratios were adjusted for confounding by high dimensional propensity scores. Meta-analytic methods estimated overall effects across participating sites. SETTING:Seven Canadian provinces and two databases in the United Kingdom and the United States. PARTICIPANTS:2,067,639 patients aged 40 years or older and newly treated with statins between 1 January 1997 and 30 April 2008. Each person hospitalized for acute kidney injury was matched with ten controls. INTERVENTION:A dispensing event was new if no cholesterol lowering drug or niacin prescription was dispensed in the previous year. High potency statin treatment was defined as ≥ 10 mg rosuvastatin, ≥ 20 mg atorvastatin, and ≥ 40 mg simvastatin; all other statin treatments were defined as low potency. Statin potency groups were further divided into cohorts with or without chronic kidney disease. MAIN OUTCOME MEASURE:Relative hospitalization rates for acute kidney injury. RESULTS:Of more than two million statin users (2,008,003 with non-chronic kidney disease; 59,636 with chronic kidney disease), patients with similar propensity scores were comparable on measured characteristics. Within 120 days of current treatment, there were 4691 hospitalizations for acute kidney injury in patients with non-chronic kidney injury, and 1896 hospitalizations in those with chronic kidney injury. In patients with non-chronic kidney disease, current users of high potency statins were 34% more likely to be hospitalized with acute kidney injury within 120 days after starting treatment (fixed effect rate ratio 1.34, 95% confidence interval 1.25 to 1.43). Users of high potency statins with chronic kidney disease did not have as large an increase in admission rate (1.10, 0.99 to 1.23). χ(2) tests for heterogeneity confirmed that the observed association was robust across participating sites. CONCLUSIONS:Use of high potency statins is associated with an increased rate of diagnosis for acute kidney injury in hospital admissions compared with low potency statins. The effect seems to be strongest in the first 120 days after initiation of statin treatment.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Dormuth CR,Hemmelgarn BR,Paterson JM,James MT,Teare GF,Raymond CB,Lafrance JP,Levy A,Garg AX,Ernst P,Canadian Network for Observational Drug Effect Studies.doi
10.1136/bmj.f880subject
Has Abstractpub_date
2013-03-18 00:00:00pages
f880eissn
0959-8138issn
1756-1833journal_volume
346pub_type
杂志文章,meta分析,多中心研究abstract:OBJECTIVE:To investigate the risks of adverse pregnancy and birth outcomes for treated and untreated bipolar disorder during pregnancy. DESIGN:Population based cohort study using data from national health registers. SETTING:Sweden. PARTICIPANTS:332,137 women with a last menstrual period anytime after 1 July 2005 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e7085
更新日期:2012-11-08 00:00:00
abstract::The identification of the gene for cystic fibrosis has led to the possibility of population based screening for carriers of cystic fibrosis to identify couples at risk of having an affected child. Pilot studies have shown that screening is feasible and does not cause untoward anxiety, though the uptake of testing vari...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6908.849
更新日期:1993-10-02 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of classroom based cognitive behavioural therapy with attention control and usual school provision for adolescents at high risk of depression. DESIGN:Three arm parallel cluster randomised controlled trial. SETTING:Eight UK secondary schools. PARTICIPANTS:Adolescents (n=5030) ag...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.e6058
更新日期:2012-10-05 00:00:00
abstract:OBJECTIVE:To evaluate systematically the review literature on type 2 diabetes to assess transmission of the findings of the United Kingdom prospective diabetes study (UKPDS), an important source of recent valid patient oriented evidence that matters (POEMs). DESIGN:Inception cohort analysis of the recent medical liter...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.327.7409.266
更新日期:2003-08-02 00:00:00
abstract:OBJECTIVE:To describe the characteristics at birth of children conceived by in vitro fertilisation (IVF) or by gamete intrafallopian transfer (GIFT) and to assess whether they differ from those of children conceived naturally. DESIGN:Survey of children resulting from IVF or GIFT and comparison of their characteristics...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6734.1229
更新日期:1990-05-12 00:00:00
abstract:OBJECTIVE:To assess the efficacy of high serum cholesterol concentration, raised blood pressure, and smoking as predictors of coronary heart disease. DESIGN:Prospective cohort study of middle aged men conducted over 25 years. SETTING:Finish components of an ongoing international study (seven countries study). PARTIC...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6691.81
更新日期:1989-07-08 00:00:00
abstract::The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and ju...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6948.184
更新日期:1994-07-16 00:00:00
abstract:OBJECTIVE:To describe the experiences of authors of Cochrane reviews in searching for, getting access to, and using unpublished data. DESIGN:Cross sectional study. SETTING:Cochrane reviews. PARTICIPANTS:2184 corresponding authors of Cochrane reviews as of May 2012. MAIN OUTCOME MEASURE:Frequencies of responses to o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f2231
更新日期:2013-04-23 00:00:00
abstract:OBJECTIVE:Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregna...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38300.665301.3A
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To determine whether the use of the UK clinical aptitude test (UKCAT) in the medical schools admissions process reduces the relative disadvantage encountered by certain sociodemographic groups. DESIGN:Prospective cohort study. SETTING:Applicants to 22 UK medical schools in 2009 that were members of the cons...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e1805
更新日期:2012-04-17 00:00:00
abstract:OBJECTIVES:To explore the assumptions underlying consumers' responses to questions of resource priorities in the NHS. DESIGN:Qualitative analysis of semi-structured interviews with a heterogeneous sample of 16 patients drawn from a general practice. RESULTS:Interviewees were not persuaded that they had a legitimate r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7013.1137
更新日期:1995-10-28 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy. DESIGN:Randomised controlled trial. SETTING:Neurology outpatient clinics in three Dutch hospitals. PARTICIPANTS:205 patients with symptoms and signs of cervica...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b3883
更新日期:2009-10-07 00:00:00
abstract:OBJECTIVE:To investigate the contribution of neuroleptic drugs to cognitive decline in dementia. DESIGN:Two year prospective, longitudinal study consisting of interviews every four months, with necropsy follow up. SETTING:Community settings in Oxfordshire. SUBJECTS:71 subjects with dementia, initially living at home...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7076.266
更新日期:1997-01-25 00:00:00
abstract:OBJECTIVE:To analyse the cost effectiveness of a national programme to screen blood donors for infection with the human T cell leukaemia/lymphoma virus. DESIGN:Three models for calculating the costs and benefits of screening were developed. The first model analysed the cost of continuously testing all donations; the s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7142.1417
更新日期:1998-05-09 00:00:00
abstract:OBJECTIVE:To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver. DESIGN:Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300). SETTING:Metab...
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.299.6709.1202
更新日期:1989-11-11 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...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.324.7332.274
更新日期:2002-02-02 00:00:00
abstract:OBJECTIVE:To determine whether the link suggested between growth in utero and during infancy and death from cardiovascular disease in men is also present in women. DESIGN:Follow up study of women and men whose birth weight and weight at 1 year of age had been recorded. SETTING:Hertfordshire, England. SUBJECTS:5585 w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6918.1519
更新日期:1993-12-11 00:00:00
abstract::Objective To characterize the prospective controlled clinical studies for all novel drugs that were initially approved by the Food and Drug Administration on the basis of limited evidence.Design Systematic review.Data sources Drugs@FDA database and PubMed.Study inclusion All prospective controlled clinical studies pub...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.j1680
更新日期:2017-05-03 00:00:00
abstract:OBJECTIVES:To determine whether fibrinogen and lipid concentrations are risk factors for ischaemic stroke. DESIGN:Case-control study with a population based comparison within the overall study. SETTING:Oxfordshire community stroke project and a neurology clinic. SUBJECTS:105 patients who had a transient ischaemic at...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6803.605
更新日期:1991-09-14 00:00:00
abstract:OBJECTIVE:To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia. DESIGN:Retrospective cohort study. SETTING:University Hospital, Helsinki, Finland. PARTICIPANTS:7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38663.459039.7C
更新日期:2005-11-19 00:00:00
abstract:OBJECTIVE:To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. DESIGN:Historical cohort study, with cohort members followed up to December 2004. DATA SOURCE:Archive of UK government research facility at Porton Down, UK military personnel rec...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.b655
更新日期:2009-03-24 00:00:00
abstract:OBJECTIVE:To compare neonatal mortality and morbidity in term infants presenting by the breech and delivered vaginally or by caesarean section. DESIGN:Population based comparison of outcomes. Data derived from the St Mary's maternity information system. SETTING:North West Thames Regional Health Authority, 1988-90. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6856.746
更新日期:1992-09-26 00:00:00
abstract:OBJECTIVE:To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN:Prospective audit of referrals from a group practice over one year. SETTING:Six handed practice in a southern coastal town. SUBJECTS:All patients referred during the study period for whom a copy o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6701.722
更新日期:1989-09-16 00:00:00
abstract:OBJECTIVE:To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN:Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING:Obstetric department and neonatal department...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39405.539282.BE
更新日期:2008-01-12 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 measure the prevalence of breast feeding and to examine the value of using information collected on Guthrie cards (used for detecting inherited metabolic disease and hypothyroidism when newborn infants are 7 days old) to calculate this prevalence. DESIGN:Analysis, by geographical area and maternity unit, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6932.824
更新日期:1994-03-26 00:00:00
abstract:OBJECTIVES:To identify factors that differentiate between effective and ineffective computerised clinical decision support systems in terms of improvements in the process of care or in patient outcomes. DESIGN:Meta-regression analysis of randomised controlled trials. DATA SOURCES:A database of features and effects of...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.f657
更新日期:2013-02-14 00:00:00
abstract::The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7221.1358
更新日期:1999-11-20 00:00:00
abstract:OBJECTIVE:To determine the implications of variation in mortality associated with use of weapons in different contexts. DESIGN:Literature review. SETTINGS:Armed conflicts and civilian mass shootings, 1929-96. MAIN OUTCOME MEASURE:Mortality from wounds. RESULTS:During the fighting of war the number of people wounded...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7207.407
更新日期:1999-08-14 00:00:00