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XIII. How to Use an Article on Economic Analysis of Clinical Practice A. Are the Results of the Study Valid?

Michael F. Drummond, PhD; W. Scott Richardson, MD; Bernie J. O'Brien, PhD; Mitchell Levine, MD; Daren Heyland, MD

JAMA. 1997;277(19):1552-1557.

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

CLINICAL SCENARIO

You are a general internist on the staff of a large community hospital. Your chief of medicine knows of your interest in evidence-based medicine, and she asks you to help her solve a problem. The hospital's pharmacy and therapeutics committee has been trying to decide on formulary guidelines for the use of streptokinase or tissue-type plasminogen activator (t-PA) in the treatment of acute myocardial infarction (AMI). Members of the committee have been arguing for weeks about the Global Utlization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial¹ and whether the added expense of t-PA is worth it. The committee has reached an impasse and has asked the chief of medicine for some outside help to reach a good decision. Knowing that the hospital faces pressure to keep costs down, the chief wants good information about this question to bring to the next committee . . . [Full Text PDF of this Article]

Author Affiliations
for the Evidence-Based Medicine Working Group

From the Centre for Health Economics, University of York, York, England (Dr Drummond); Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (Dr Richardson); Department of Clinical Epidemiology and Biostatistics, McMaster University and Centre for Evaluation of Medicines, St Joseph's Hospital, Hamilton, Ontario (Drs O'Brien and Levine); and Royal Alexandra Hospital, Edmonton, Alberta (Dr Heyland).

Footnotes
The original list of members (with affiliations) appears in the first article of this series (JAMA. 1993;270: 2093-2095). A list of new members appears in the 10th article of the series (JAMA. 1996;275:1435-1439). The following members contributed to this article: Gordon H. Guyatt, MD, MSc (chair); Roman Jaeschke, MD, MSc; Deborah J. Cook, MD, MSc; Hertzel Gerstein, MD, MSc; Stephen Walter, PhD; John Williams, Jr, MD, MHS; and C. David Naylor, MD, MSc, DPhil.

Reprints: Gordon H. Guyatt, MD, MSc, McMaster University Health Sciences Centre, 1200 Main St W, Room 2C12, Hamilton, Ontario, Canada L8N 3Z5.

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

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