Abstract:
OBJECTIVE:To determine whether short-term, oral low dose prednisolone (< or = 15 mg daily) is superior to placebo and non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN:Meta-analysis of randomised trials of oral corticosteroids compared with placebo or a non-steroidal anti-inflammatory drug. SETTING:Trials conducted anywhere in the world. SUBJECTS:Patients with rheumatoid arthritis. MAIN OUTCOME MEASURES:Joint tenderness, pain, and grip strength. Outcomes measured on different scales were combined by using the standardised effect size (difference in effect divided by SD of the measurements). RESULTS:Ten studies were included in the meta-analysis. Prednisolone had a marked effect over placebo on joint tenderness (standardised effect size 1.31; 95% confidence interval 0.78 to 1.83), pain (1.75; 0.87 to 2.64), and grip strength (0.41; 0.13 to 0.69). Measured in the original units the differences were 12 (6 to 18) tender joints and 22 mm Hg (5 mm Hg to 40 mm Hg) for grip strength. Prednisolone also had a greater effect than non-steroidal anti-inflammatory drugs on joint tenderness (0.63; 0.11 to 1.16) and pain (1.25; 0.26 to 2.24), whereas the difference in grip strength was not significant (0.31; -0.02 to 0.64). Measured in the original units the differences were 9 (5 to 12) tender joints and 12 mm Hg (-6 mm Hg to 31 mm Hg). The risk of adverse effects during moderate and long term use seemed acceptable. CONCLUSION:Prednisolone in low doses (< or = 15 mg daily) may be used intermittently in patients with rheumatoid arthritis, particularly if the disease cannot be controlled by other means.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Gøtzsche PC,Johansen HKdoi
10.1136/bmj.316.7134.811subject
Has Abstractpub_date
1998-03-14 00:00:00pages
811-8issue
7134eissn
0959-8138issn
1756-1833journal_volume
316pub_type
杂志文章,meta分析abstract::A questionnaire describing five hypothetical patients intending to travel to different countries was sent to 113 general practitioners, who were asked to state which patients they would recommend cholera vaccination to. The response rate was 80%. The general practitioners' recommendations were compared with those of t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6716.25
更新日期:1990-01-06 00:00:00
abstract:OBJECTIVE:To examine doctors' perspectives about their experiences with handheld computers in clinical practice. DESIGN:Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. SETTING:Six practice settings across the United States and two additional focus group sessi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.328.7449.1162
更新日期:2004-05-15 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:OBJECTIVES:To investigate the association between environmental tobacco smoke, plasma cotinine concentration, and respiratory cancer or death. DESIGN:Nested case-control study within the European prospective investigation into cancer and nutrition (EPIC). PARTICIPANTS:303,020 people from the EPIC cohort (total 500,00...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38327.648472.82
更新日期:2005-02-05 00:00:00
abstract:OBJECTIVES:To investigate the effect of Chlamydia pneumoniae infection on future development of ischaemic heart disease and mortality. DESIGN:Prospective longitudinal study. SETTING:Caerphilly, South Wales. SUBJECTS:Plasma specimens were collected during 1979-83 from 1773 men aged 45-59 years. These were tested for ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7190.1035
更新日期:1999-04-17 00:00:00
abstract:OBJECTIVE:To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians. DESIGN:Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f5446
更新日期:2013-10-01 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:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.325.7370.925
更新日期:2002-10-26 00:00:00
abstract:OBJECTIVE:To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN:Prospective study of 12 consecutive patients. SETTING:Spinal injuries unit and university gastrointestinal physiology department. PA...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6738.1494
更新日期:1990-06-09 00:00:00
abstract:OBJECTIVE:To determine whether peer review medical audit in a primary care setting changes clinical behaviour in relation to the management of hypertension. DESIGN:Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre-educational and post-educational mana...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7085.942
更新日期:1997-03-29 00:00:00
abstract:OBJECTIVES:To determine whether there are important differences in performance between group practices and singlehanded general practitioners and the extent to which any differences are explained by practice characteristics such as deprivation. DESIGN:Cross sectional survey. SETTING:206 singlehanded practices and 606...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.323.7308.320
更新日期:2001-08-11 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 study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus. DESIGN:Population based study of diabetic twins. SETTING:Danish population. SUBJECTS:18 monozygotic and 36 dizygotic twin pairs with one or both pa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7094.1575
更新日期:1997-05-31 00:00:00
abstract:OBJECTIVE:To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN:Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.301.6760.1074
更新日期:1990-11-10 00:00:00
abstract:OBJECTIVE:To determine whether abnormal results for liver function tests are investigated in primary care and findings on full investigation. DESIGN:Retrospective audit and prospective clinical investigation. SETTING:University hospital and surrounding general practices serving around 330 000 people. SUBJECTS:Adults...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7281.276
更新日期:2001-02-03 00:00:00
abstract:OBJECTIVE:To examine variations in teenage pregnancy rates in Trent region and to determine possible associations with local general practice characteristics such as the age and sex of the doctors. DESIGN:Cross sectional survey. SETTING:All 826 general practices in Trent region in existence between 1994 and 1997. SU...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.320.7238.842
更新日期:2000-03-25 00:00:00
abstract:OBJECTIVE:To explore geographical and sociodemographic factors associated with variation in equity in access to total hip and knee replacement surgery. DESIGN:Combining small area estimates of need and provision to explore equity in access to care. SETTING:English census wards. SUBJECTS:Patients throughout England w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c4092
更新日期:2010-08-11 00:00:00
abstract:OBJECTIVE:To analyse the relation between treated blood pressure and concomitant risk factor and morbidity from acute myocardial infarction. DESIGN:Prospective longitudinal study. Treated blood pressures and other variables were used to predict acute myocardial infarction. SETTING:Primary health care in Skaraborg, Sw...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6930.681
更新日期:1994-03-12 00:00:00
abstract:OBJECTIVE:To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients. DESIGN:Randomised controlled trial. SETTING:Home based intervention in heart failure patients. PARTICIPANTS:293 patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.39164.568183.AE
更新日期:2007-05-26 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::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:OBJECTIVE:To examine the association between obstetric epidural anaesthesia and subsequent long term problems. DESIGN:Postal questionnaire on health problems after childbirth linked to maternity case note data. SETTING:Maternity hospital in Birmingham. SUBJECTS:11701 women who delivered their most recent child durin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6837.1279
更新日期:1992-05-16 00:00:00
abstract:PROBLEM:Prophylactic treatment and follow-up after exposure to HIV, hepatitis B, and hepatitis C outside hospital needs to be improved. BACKGROUND AND SETTING:Until January 2000, people in Amsterdam could report exposure outside hospital to either a hospital or the municipal health service. If they reported to the mun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.330.7495.825
更新日期:2005-04-09 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 investigate explanations for social inequalities in health with respect to health related social mobility and cumulative socioeconomic circumstances over the first three decades of life. DESIGN:Longitudinal follow up. SETTING:Great Britain. SUBJECTS:Data from the 1958 birth cohort study (all children bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7055.449
更新日期:1996-08-24 00:00:00
abstract::This article reports the success of WHO in eliminating onchocerciasis or river blindness in most of West Africa. The onchocerciasis control program was able to save 100,000 people at immediate risk of contracting the disease and prevented the infection of about 12 million children. About 1.25 million onchocercal inf...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.319.7217.1090a
更新日期:1999-10-23 00:00:00
abstract::Stroke is the leading cause of long term disability in developed countries and one of the top causes of mortality worldwide. The past decade has seen substantial advances in the diagnostic and treatment options available to minimize the impact of acute ischemic stroke. The key first step in stroke care is early identi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.l6983
更新日期:2020-02-13 00:00:00
abstract::An association between vasectomy and the development of testicular tumors, and the importance of testicular examinations both before and after a vasectomy is discussed. Patients diagnosed with testicular tumors within the last ten years were examined at Bangour General Hospital in Scotland. From 1977-87, 37 patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6721.370
更新日期:1990-02-10 00:00:00
abstract:OBJECTIVE:To examine the relation between energy intake in childhood and adult mortality from cancer. STUDY DESIGN:Cohort study. SETTING:16 rural and urban centres in England and Scotland. SUBJECTS:3834 people who took part in Lord Boyd Orr's Carnegie survey of family diet and health in prewar Britain between 1937 a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7130.499
更新日期:1998-02-14 00:00:00
abstract:OBJECTIVES:To determine general practitioners' responses to and explanations for variation in rates of referral to hospital and how feedback of data on rates of referral could be used to facilitate practices in auditing their own referral behaviour. DESIGN:Visits by audit facilitators to general practices after feedba...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6917.1465
更新日期:1993-12-04 00:00:00