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 literature. STUDIES REVIEWED:Thirty five reviews on treatment of type 2 diabetes. MAIN OUTCOME MEASURES:Presentation of three types of information from UKPDS in review articles: recommendations based on patient oriented outcomes of study; recommendations contradicted by patient oriented outcomes of study; and recommendations based on disease oriented outcomes for which no patient oriented evidence exists. RESULTS:Only six of the reviews included the POEM that tight blood glucose control had no effect on diabetes related or overall mortality. Just seven mentioned that metformin treatment was associated with decreased mortality. Most (30) of the reviews did not report that diabetic patients with hypertension benefit more from good blood pressure control than good blood glucose control. No review pointed out that treatment of overweight patients with type 2 diabetes with insulin or sulphonylurea drugs had no effect on microvascular or macrovascular outcomes. Thirteen reviews recommended drugs as first line treatment for which we do not have patient oriented outcomes data. The average validity assessment score was 1.3 out of a possible score of 15 (95% confidence interval 0.9 to 1.8). CONCLUSIONS:Review articles on the treatment of type 2 diabetes have not accurately transmitted the valid POEM results of the UKPDS to clinicians. Clinicians relying on review articles written by experts as a source of valid POEMs may be misled.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Shaughnessy AF,Slawson DCdoi
10.1136/bmj.327.7409.266keywords:
subject
Has Abstractpub_date
2003-08-02 00:00:00pages
266issue
7409eissn
0959-8138issn
1756-1833pii
327/7409/266journal_volume
327pub_type
杂志文章,评审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...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
abstract:OBJECTIVE:To determine the prevalence of sexually transmitted diseases in patients with normal and abnormal cervical smears. DESIGN:A prospective study of asymptomatic women with normal cervical smears attending their general practitioner and newly referred patients with abnormal smears attending a colposcopy clinic. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6768.82
更新日期:1991-01-12 00:00:00
abstract::First aid, as a profession in its own right, has a history of only 120 years. It evolved from the teachings of the Royal Humane Society and military surgeons, who saw the wisdom of training in splinting and bandaging for battlefield wounds. In 1878 two Aberdeenshire military officers, Surgeon-Major Peter Shepherd of t...
journal_title:BMJ (Clinical research ed.)
pub_type: 传,历史文章,杂志文章
doi:10.1136/bmj.309.6970.1718
更新日期:1994-12-24 00:00:00
abstract:OBJECTIVE:To describe the current methods used by English medical schools to identify prospective medical students for admission to the five year degree course. DESIGN:Review study including documentary analysis and interviews with admissions tutors. SETTING:All schools (n = 22) participating in the national expansio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38768.590174.55
更新日期:2006-04-29 00:00:00
abstract:OBJECTIVE:To determine whether the intervention of a physiotherapist improved mobility in patients seen more than one year after stroke. DESIGN:Randomised crossover trial comparing two groups offered intervention by a physiotherapist, one immediately after entry into the trial and the other after a delay of three mont...
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.304.6827.609
更新日期:1992-03-07 00:00:00
abstract::Prediction models are developed to aid health care providers in estimating the probability or risk that a specific disease or condition is present (diagnostic models) or that a specific event will occur in the future (prognostic models), to inform their decision making. However, the overwhelming evidence shows that th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g7594
更新日期:2015-01-07 00:00:00
abstract:OBJECTIVE:To determine the effect of combinations of statins, aspirin, beta blockers, and angiotensin converting enzyme inhibitors in the secondary prevention of all cause mortality in patients with ischaemic heart disease. DESIGN:Open prospective cohort study with nested case-control analysis. SETTING:1.18 million p...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.330.7499.1059
更新日期:2005-05-07 00:00:00
abstract:OBJECTIVE:To examine changes in immunisation performance in Grampian region after the introduction of the 1990 contract for general practitioners. DESIGN:Retrospective descriptive study using data held on the Grampian immunisation record system's computer. SETTING:All 95 general practices in Grampian region (313 gene...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6830.816
更新日期:1992-03-28 00:00:00
abstract:OBJECTIVE:To investigate the long term effects of continuous subcutaneous insulin infusion (insulin pump therapy) on cardiovascular diseases and mortality in people with type 1 diabetes. DESIGN:Observational study. SETTING:Swedish National Diabetes Register, Sweden 2005-12. PARTICIPANTS:18,168 people with type 1 dia...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3234
更新日期:2015-06-22 00:00:00
abstract:OBJECTIVE: To directly compare the performance and externally validate the three most studied prediction tools for osteoporotic fractures-QFracture, FRAX, and Garvan-using data from electronic health records. DESIGN: Retrospective cohort study. SETTING: Payer provider healthcare organisation in Israel. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i6755
更新日期:2017-01-19 00:00:00
abstract:OBJECTIVE:To determine the association of resting echocardiography before elective intermediate to high risk non-cardiac surgery with survival and length of hospital stay. DESIGN:Population based retrospective cohort study. SETTING:Acute care hospitals in Ontario, Canada, between 1 April 1999 and 31 March 2008. PART...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d3695
更新日期:2011-06-30 00:00:00
abstract:OBJECTIVE:To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN:Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6756.835
更新日期:1990-10-13 00:00:00
abstract:OBJECTIVES:To evaluate the long term effects of perioperative beta blockade on mortality and cardiac morbidity in patients with diabetes undergoing major non-cardiac surgery. DESIGN:Randomised placebo controlled and blinded multicentre trial. Analyses were by intention to treat. SETTING:University anaesthesia and sur...
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.332.7556.1482
更新日期:2006-06-24 00:00:00
abstract:OBJECTIVE:To assess the efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy, a placebo surgical intervention, and with a non-operative alternative, exercise therapy, in a more pragmatic setting. DESIGN:Multicentre, three group, randomised, double blind, sham controlled ...
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.k2860
更新日期:2018-07-19 00:00:00
abstract:OBJECTIVE:To obtain data on sexual contact between doctors and their patients. DESIGN:Anonymous questionnaire with 17 items sent to all working gynaecologists (n = 595) and all ear, nose, and throat specialists (n = 380) in the Netherlands. RESULTS:Response rate was 74%; a total 64 doctors gave a reason for not compl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6841.1531
更新日期:1992-06-13 00:00:00
abstract:OBJECTIVES:To measure, in a service setting, the effect of magnetic resonance imaging on diagnosis, diagnostic certainty, and patient management in the neurosciences; to measure the cost per patient scanned; to estimate the marginal cost of imaging and compare this with its diagnostic impact; to measure changes in pati...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6815.1435
更新日期:1991-12-07 00:00:00
abstract::The World Health Organization's (WHO) definition of health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" had the merit of widening concepts of health to include psychological and social aspects, but is of no practical use. In fact, this statement m...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7091.1409
更新日期:1997-05-10 00:00:00
abstract::Robots designed for surgery have three main advantages over humans. They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision. Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical De...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7018.1479
更新日期:1995-12-02 00:00:00
abstract:OBJECTIVES:To describe the change in first day infant mortality during 1935-87. To examine the hypothesis that excess first day mortality in the 1950s and 1960s was attributable to restricting oxygen for sick newborn infants. DESIGN:Time series analysis of first day infant mortality and stillbirth rates. SETTING:Engl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6823.343
更新日期:1992-02-08 00:00:00
abstract::An investigation was conducted to determine the vehicle of infection of an outbreak of food poisoning in a large metropolitan building early in 1988. A questionnaire was distributed to 700 people who had eaten in the building during the week of the outbreak, and attack rates for specific food were calculated. Food and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6666.99
更新日期:1989-01-14 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.d2202
更新日期:2011-04-26 00:00:00
abstract::A total of 22,552 workers employed by the Atomic Weapons Establishment between 1951 and 1982 were followed up for an average of 18.6 years. Of the 3115 who died, 865 (28%) died of cancer. Mortality was 23% lower than the national average for all causes of death and 18% lower for cancer. These low rates were consistent...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6651.757
更新日期:1988-09-24 00:00:00
abstract:OBJECTIVE:To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense). DESIGN:Systematic review. DATA SOURCES:Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departme...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.a2813
更新日期:2008-12-17 00:00:00
abstract::A study was performed to assess whether the existing differential capitation fees for general practitioners accurately assess differential workloads. Data from the third morbidity study in general practice were used to compare capitation fees with relative workload in differing age and sex groups. The population mix w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6654.966
更新日期:1988-10-15 00:00:00
abstract:OBJECTIVE:To assess the associations between childhood and adulthood social class and insulin resistance. DESIGN:Cross sectional survey. SETTING:23 towns across England, Scotland, and Wales. PARTICIPANTS:4286 women aged 60-79 years. MAIN OUTCOME MEASURES:Insulin resistance and other cardiovascular disease risk fact...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7368.805
更新日期:2002-10-12 00:00:00
abstract:OBJECTIVE:To compare patient outcomes of restrictive versus liberal blood transfusion strategies in patients with cardiovascular disease not undergoing cardiac surgery. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Randomised controlled trials involving a threshold for red blood cell transfusion in hospita...
journal_title:BMJ (Clinical research ed.)
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
abstract:OBJECTIVE:To assess body shape trajectories in early and middle life in relation to risk of mortality. DESIGN:Prospective cohort study. SETTING:Nurses' Health Study and Health Professionals Follow-up Study. POPULATION:80 266 women and 36 622 men who recalled their body shape at ages 5, 10, 20, 30, and 40 years and p...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.i2195
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVE:To see whether the issue of AIDS has influenced the observed decline in blood donation in Scotland. DESIGN:Two methods: a quantitative survey using personal interviews based on a questionnaire and a qualitative survey based on group discussions. SETTING:Interviews based on the questionnaire were conducted i...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6679.1012
更新日期:1989-04-15 00:00:00
abstract:OBJECTIVE:To compare the prevalence of silent myocardial ischaemia associated with coronary artery disease in diabetic subjects with that in controls of similar age and sex. DESIGN:A controlled study in which subjects with positive findings on exercise electrocardiography, 24 hour electrocardiographic recording, or dy...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6743.92
更新日期:1990-07-14 00:00:00
abstract:OBJECTIVES:To evaluate the use of a maternity unit run by general practitioners and midwives, describing the outcome of labour in an unselected group of women and quantifying the contribution made by general practitioners. DESIGN:Retrospective population based review of obstetric patients who had access to an isolated...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7025.223
更新日期:1996-01-27 00:00:00