This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

X. How to Use an Article Reporting Variations in the Outcomes of Health Services

C. David Naylor, MD, DPhil; Gordon H. Guyatt, MD, MSc; Evidence-Based Medicine Working Group; Eric Bass, MD, MPH; Hertzel Gerstein, MD, MSc; Daren Heyland, MD, MSc; Ann Holbrook, MD, PharmD, MSc; Virginia Moyer, MD, MPH; Tom Newman, MD; Andrew Oxman, MD, MSc; W. Scott Richardson, MD; Peter Tugwell, MD, MSc; John Williams, Jr, MD, MHS

JAMA. 1996;275(7):554-558.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CASE SCENARIO

Your patient, a 78-year-old retired internist, has been complaining of increasing symptoms of benign prostatic hyperplasia. He has long-standing hypertension and coronary artery disease, with remote anterolateral myocardial infarction and bypass surgery 10 years ago. His left ventricular ejection fraction was recently documented at 20%, and he has been started on an angiotensin-converting enzyme inhibitor. Rectal examination confirms a moderately enlarged prostate, without irregularities, nodularity, or tenderness. As you discuss management options, your patient insists that transurethral prostate surgery is dangerous and that international studies of thousands of patients have proved that, as he puts it, "old-fashioned open prostatectomy is safer than that keyhole surgery." You prescribe a trial of an -blocker, terazosin, and arrange to see him again. However, the retired internist sounds so convinced that you also resolve to look into the evidence about the two forms of prostatectomy.

THE SEARCH

Later, you sit down in . . . [Full Text PDF of this Article]

Author Affiliations
From the Institute for Clinical Evaluative Sciences, Ontario, North York, the Clinical Epidemiology and Health Care Research Program, Sunnybrook Unit, and the Departments of Medicine and Surgery, University of Toronto (Ontario) (Dr Naylor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Dr Guyatt).

Footnotes
Users' Guides to the Medical Literature section editor: Drummond Rennie, MD, Deputy Editor (West), JAMA.

A complete list of members (with affiliations) of the Evidence-Based Medicine Working Group appears In the first article of this series (JAMA. 1993:270:2093-2095). The following members contributed to this article: Eric Bass, MD, MPH; Hertzel Gersteln, MD, MSc; Daren Heyland, MD, MSc; Ann Holbrook, MD, PharmD, MSc; Virginia Moyer, MD, MPH; Tom Newman, MD; Andrew Oxman, MD, MSc; W. Scott Richardson, MD; Peter Tugwell, MD, MSc; and John Williams, Jr, MD, MHS.

Corresponding author: C. David Naylor, MD, DPhll, Institute for Clinical Evaluative Sciences In Ontario, G-106, Sunnybrook Health Science Centre, 2075 Bayview Ave, North York, Ontario, Canada M4N 3M5.

Reprint requests to Room 2C12, McMaster University Health Sciences Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Guyatt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?