 |
|
Users' Guides to the Medical Literature
XIX. Applying Clinical Trial ResultsB. Guidelines for Determining Whether a Drug Is Exerting (More Than) a Class Effect
Finlay A. McAlister, MD, FRCPC;
Andreas Laupacis, MD, MSc, FRCPC;
George A. Wells, MSc, PhD;
David L. Sackett, FRSC, MD, FRCP;
for the Evidence-Based Medicine Working Group
JAMA. 1999;282:1371-1377.
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
INTRODUCTION
Most classes of drugs include multiple compounds. The opinions of clinicians, manufacturers, and purchasers may differ as to whether a particular drug is more efficacious, safer, or more cost-effective than others in its class.1 In this article, we review the types of evidence commonly cited to support the prescribing of a particular drug rather than another of the same class and provide a hierarchy for grading studies that compare a drug with another of the same class, expanding on our discussion in part A of this Users' Guide.2
CLINICAL SCENARIOS
The Clinician
As a clinician, you care for many patients with elevated serum cholesterol levels. A speaker at a recent continuing medical education event reviewed the benefits of cholesterol-lowering therapy, particularly with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors . . . [Full Text of this Article] The Policymaker
DRUG CLASSES
Risks of Assuming a Class Effect Levels of Evidence Level 1 Level 2 Level 3 Level 4 Other Considerations Amount of Efficacy Evidence Safety Convenience/Compliance Cost
RESOLUTION OF SCENARIOS
The Clinician The Policymaker
CONCLUSION
Author Affiliations: National Health Service Research and Development Centre for Evidence-Based Medicine, John Radcliffe Hospital, Oxford, England (Drs McAlister and Sackett); Division of General Internal Medicine, Ottawa Hospital (Dr Laupacis), and Clinical Epidemiology Unit, Loeb Health Research Institute (Drs Laupacis and Wells), Ottawa, Ontario.
RELATED LETTER
Evaluating Clinical Studies of Drug Efficacy
Peter T. Donnan, Douglas M. Steinke, Jixian Wang, Peter G. Davey, Thomas M. MacDonald, Finlay McAlister, Andreas Laupacis, George Wells, and David Sackett
JAMA. 2000;283(9):1139-1140.
EXTRACT
| FULL TEXT
RELATED ARTICLE
October 13, 1999
JAMA. 1999;282(14):1393-1394.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Generalizability of the Results of Randomized Trials
Weiss et al.
Arch Intern Med 2008;168:133-135.
FULL TEXT
Accreditation Council for Graduate Medical Education Competencies: Practice-Based Learning and Systems-Based Practice
Moskowitz and Nash
American Journal of Medical Quality 2007;22:351-382.
Commercially Funded and United States-Based Research Is More Likely to Be Published; Good-Quality Studies with Negative Outcomes Are Not
Lynch et al.
JBJS 2007;89:1010-1018.
ABSTRACT
| FULL TEXT
Is Molecular Profiling Ready for Use in Clinical Decision Making?
Ioannidis
The Oncologist 2007;12:301-311.
ABSTRACT
| FULL TEXT
Intensive Insulin Therapy in Critical Illness
Angus and Abraham
Am. J. Respir. Crit. Care Med. 2005;172:1358-1359.
FULL TEXT
{beta} blockers for elective surgery in elderly patients: population based, retrospective cohort study
Redelmeier et al.
BMJ 2005;331:932.
ABSTRACT
| FULL TEXT
Effect of Different Antilipidemic Agents and Diets on Mortality: A Systematic Review
Studer et al.
Arch Intern Med 2005;165:725-730.
ABSTRACT
| FULL TEXT
A Randomized Trial Comparing 2 Low-Molecular-Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism
Wells et al.
Arch Intern Med 2005;165:733-738.
ABSTRACT
| FULL TEXT
Is Improved Survival a Class Effect of Angiotensin-Converting Enzyme Inhibitors?
Hennessy and Kimmel
ANN INTERN MED 2004;141:157-158.
FULL TEXT
Comparison of the efficacy of the tumour necrosis factor {alpha} blocking agents adalimumab, etanercept, and infliximab when added to methotrexate in patients with active rheumatoid arthritis
Hochberg et al.
Ann Rheum Dis 2003;62:ii13-16.
ABSTRACT
| FULL TEXT
Effects of Computerized Physician Order Entry and Clinical Decision Support Systems on Medication Safety: A Systematic Review
Kaushal et al.
Arch Intern Med 2003;163:1409-1416.
ABSTRACT
| FULL TEXT
Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses
Song et al.
BMJ 2003;326:472-472.
ABSTRACT
| FULL TEXT
Integrating quality into the cycle of therapeutic development
Califf et al.
J Am Coll Cardiol 2002;40:1895-1901.
ABSTRACT
| FULL TEXT
Principles From Clinical Trials Relevant to Clinical Practice: Part II
Califf and DeMets
Circulation 2002;106:1172-1175.
FULL TEXT
Prevention of Relapse in Schizophrenia
Geddes
NEJM 2002;346:56-58.
FULL TEXT
Observation and Experiment with the Efficacy of Drugs: A Warning Example from a Cohort of Nonsteroidal Anti-inflammatory and Ulcer-healing Drug Users
McMahon
Am J Epidemiol 2001;154:557-562.
ABSTRACT
| FULL TEXT
Erythropoietin: A Paradigm for the Development of Practice Guidelines
Rizzo et al.
ASH Education Book 2001;2001:10-30.
ABSTRACT
| FULL TEXT
GENERAL CARDIOLOGY: Evaluation of large scale clinical trials and their application to usual practice
Tonkin
Heart 2000;84:679-684.
FULL TEXT
Evaluating Clinical Studies of Drug Efficacy
Donnan et al.
JAMA 2000;283:1139-1140.
FULL TEXT
|
