163 results on '"Mulrow, CD."'
Search Results
2. Physical Therapy Provides Modest Benefits for Frail Nursing Home Residents
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Mulrow, CD, Gerety, MB, and Kanten, D
- Published
- 1994
3. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration
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Vandenbroucke, JP, Von Elm, E, Altman, DG, Gøtzsche, PC, Mulrow, CD, Pocock, SJ, Poole, C, Schlesselman, JJ, Egger, M, Vandenbroucke, JP, Von Elm, E, Altman, DG, Gøtzsche, PC, Mulrow, CD, Pocock, SJ, Poole, C, Schlesselman, JJ, and Egger, M
- Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, casecontrol studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www. strobe-statement.org/) should be helpful resources to improve reporting of observational research. © 2007 Vandenbroucke et al.
- Published
- 2007
4. St John's Wort for depression
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Linde, K, primary, Mulrow, CD, additional, Berner, M, additional, and Egger, M, additional
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- 2005
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5. St John's Wort for depression
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Linde, K, primary and Mulrow, CD, additional
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- 1998
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6. Dieting to reduce body weight for controlling hypertension in adults
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Mulrow, CD, primary, Chiquette, E, additional, Angel, L, additional, Cornell, J, additional, Summerbell, C, additional, Anagnostelis, B, additional, Brand, M, additional, and Grimm, R, additional
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- 1998
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7. Colorectal cancer screening: Clinical guidelines and rationale
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Winawer, SJ, primary, Fletcher, RH, additional, Miller, L, additional, Godlee, F, additional, Stolar, MH, additional, Mulrow, CD, additional, Woolf, SH, additional, Glick, SN, additional, Ganiats, TG, additional, Bond, JH, additional, Rosen, L, additional, Zapka, JG, additional, Olsen, SJ, additional, Giardiello, FM, additional, Sisk, JE, additional, Van Antwerp, R, additional, Brown-Davis, C, additional, Marciniak, DA, additional, and Mayer, RJ, additional
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- 1997
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8. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force.
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Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans CT, Mulrow CD, Lohr KN, Pignone, Michael P, Gaynes, Bradley N, Rushton, Jerry L, Burchell, Catherine Mills, Orleans, C Tracy, Mulrow, Cynthia D, and Lohr, Kathleen N
- Abstract
Purpose: To clarify whether screening adults for depression in primary care settings improves recognition, treatment, and clinical outcomes.Data Sources: The MEDLINE database was searched from 1994 through August 2001. Other relevant articles were located through other systematic reviews; focused searches of MEDLINE from 1966 to 1994; the Cochrane depression, anxiety, and neurosis database; hand searches of bibliographies; and extensive peer review.Study Selection: The researchers reviewed randomized trials conducted in primary care settings that examined the effect of screening for depression on identification, treatment, or health outcomes, including trials that tested integrated, systematic support for treatment after identification of depression.Data Extraction: A single reviewer abstracted the relevant data from the included articles. A second reviewer checked the accuracy of the tables against the original articles.Data Synthesis: Compared with usual care, feedback of depression screening results to providers generally increased recognition of depressive illness in adults. Studies examining the effect of screening and feedback on treatment rates and clinical outcomes had mixed results. Many trials lacked power to detect clinically important differences in outcomes. Meta-analysis suggests that overall, screening and feedback reduced the risk for persistent depression (summary relative risk, 0.87 [95% CI, 0.79 to 0.95]). Programs that integrated interventions aimed at improving recognition and treatment of patients with depression and that incorporated quality improvements in clinic systems had stronger effects than programs of feedback alone.Conclusion: Compared with usual care, screening for depression can improve outcomes, particularly when screening is coupled with system changes that help ensure adequate treatment and follow-up. [ABSTRACT FROM AUTHOR]- Published
- 2002
9. Interventions for the treatment and management of chronic fatigue syndrome: a systematic review.
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Whiting P, Bagnall A, Sowden AJ, Cornell JE, Mulrow CD, Ramírez G, Whiting, P, Bagnall, A M, Sowden, A J, Cornell, J E, Mulrow, C D, and Ramírez, G
- Abstract
Context: A variety of interventions have been used in the treatment and management of chronic fatigue syndrome (CFS). Currently, debate exists among health care professionals and patients about appropriate strategies for management.Objective: To assess the effectiveness of all interventions that have been evaluated for use in the treatment or management of CFS in adults or children.Data Sources: Nineteen specialist databases were searched from inception to either January or July 2000 for published or unpublished studies in any language. The search was updated through October 2000 using PubMed. Other sources included scanning citations, Internet searching, contacting experts, and online requests for articles.Study Selection: Controlled trials (randomized or nonrandomized) that evaluated interventions in patients diagnosed as having CFS according to any criteria were included. Study inclusion was assessed independently by 2 reviewers. Of 350 studies initially identified, 44 met inclusion criteria, including 36 randomized controlled trials and 8 controlled trials.Data Extraction: Data extraction was conducted by 1 reviewer and checked by a second. Validity assessment was carried out by 2 reviewers with disagreements resolved by consensus. A qualitative synthesis was carried out and studies were grouped according to type of intervention and outcomes assessed.Data Synthesis: The number of participants included in each trial ranged from 12 to 326, with a total of 2801 participants included in the 44 trials combined. Across the studies, 38 different outcomes were evaluated using about 130 different scales or types of measurement. Studies were grouped into 6 different categories. In the behavioral category, graded exercise therapy and cognitive behavioral therapy showed positive results and also scored highly on the validity assessment. In the immunological category, both immunoglobulin and hydrocortisone showed some limited effects but, overall, the evidence was inconclusive. There was insufficient evidence about effectiveness in the other 4 categories (pharmacological, supplements, complementary/alternative, and other interventions).Conclusions: Overall, the interventions demonstrated mixed results in terms of effectiveness. All conclusions about effectiveness should be considered together with the methodological inadequacies of the studies. Interventions which have shown promising results include cognitive behavioral therapy and graded exercise therapy. Further research into these and other treatments is required using standardized outcome measures. [ABSTRACT FROM AUTHOR]- Published
- 2001
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10. Management of mild chronic hypertension during pregnancy: a review.
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Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J, Ferrer, R L, Sibai, B M, Mulrow, C D, Chiquette, E, Stevens, K R, and Cornell, J
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- 2000
11. The medical review article revisited: has the science improved?
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McAlister FA, Clark HD, van Walraven C, Straus SE, Lawson FME, Moher D, Mulrow CD, McAlister, F A, Clark, H D, van Walraven, C, Straus, S E, Lawson, F M, Moher, D, and Mulrow, C D
- Abstract
Background: The validity of a review depends on its methodologic quality.Objective: To determine the methodologic quality of recently published review articles.Design: Critical appraisal.Setting: All reviews of clinical topics published in six general medical journals in 1996.Measurements: Explicit criteria that have been published and validated were used.Results: Of 158 review articles, only 2 satisfied all 10 methodologic criteria (median number of criteria satisfied, 1). Less than a quarter of the articles described how evidence was identified, evaluated, or integrated; 34% addressed a focused clinical question; and 39% identified gaps in existing knowledge. Of the 111 reviews that made treatment recommendations, 48% provided an estimate of the magnitude of potential benefits (and 34%, the potential adverse effects) of the treatment options, 45% cited randomized clinical trials to support their recommendations, and only 6% made any reference to costs.Conclusions: The methodologic quality of clinical review articles is highly variable, and many of these articles do not specify systematic methods. [ABSTRACT FROM AUTHOR]- Published
- 1999
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12. Hypertension in the elderly. Implications and generalizability of randomized trials.
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Mulrow CD, Cornell JA, Herrera CR, Kadri A, Farnett L, Aguilar C, Mulrow, C D, Cornell, J A, Herrera, C R, Kadri, A, Farnett, L, and Aguilar, C
- Abstract
Objective: To estimate morbidity and mortality benefits of drug therapy for hypertensive elderly subjects, compare these benefits with effects in younger subjects, and provide a framework for generalizing results derived from trials to actual patients.Data Sources: A literature search using MEDLINE from 1966 to 1993, references from reviews and trial articles, and experts.Study Selection: Randomized trials lasting at least 1 year that evaluated effects of drug treatment on morbidity and mortality outcomes in hypertensive persons.Data Extraction: Four independent reviewers appraised protocol characteristics and quality of selected trials.Data Synthesis: There were 13 trials involving 16,564 elderly persons (age 60 years and older). The prevalence of cardiovascular risk factors, cardiovascular disease, and competing comorbid diseases was lower among trial participants than the general population of hypertensive elderly persons. When the six large high-quality trials were combined, trial results showed 43 subjects (95% confidence interval [CI], 31 to 69) and 61 subjects (95% CI, 39 to 141) needed to be treated for 5 years to prevent one cerebrovascular event and one coronary heart disease event, respectively. Including the other seven trials did not change the results significantly. Only 18 subjects (95% CI, 14 to 25) needed to be treated to prevent one cardiovascular event (cerebrovascular or cardiac). Twelve trials in primarily younger and middle-aged adults involved approximately 33,000 persons. For all outcomes except cardiac mortality, two to four times as many of the younger subjects as the older subjects needed to be treated for 5 years to prevent morbid and mortal events. No significant effect on cardiac mortality was seen among younger subjects, while 78 older subjects (95% CI, 50 to 180) needed to be treated to prevent a fatal cardiac event.Conclusions: Randomized trials demonstrate that treating healthy older persons with hypertension is highly efficacious. Five-year morbidity and mortality benefits derived from trials are greater for older than younger subjects. Extrapolating benefits from trials to individual patients is difficult, but should take into account multiple issues including the patient's risk factors, preexisting cardiovascular disease, and competing comorbid illnesses. [ABSTRACT FROM AUTHOR]- Published
- 1994
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13. St John's wort for depression -- an overview and meta-analysis of randomised clinical trials.
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Linde K, Ramirez G, Mulrow CD, Pauls A, Weidenhammer W, and Melchart D
- Published
- 1996
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14. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques.
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Province MA, Hadley EC, Hornbrook MC, Lipsitz LA, Miller JP, Mulrow CD, Ory MG, Sattin RW, Tinetti ME, Wolf SL, Frailty and Injuries: Cooperative Studies of Intervention Techniques Group, Province, M A, Hadley, E C, Hornbrook, M C, Lipsitz, L A, Miller, J P, Mulrow, C D, Ory, M G, Sattin, R W, and Tinetti, M E
- Abstract
Objective: To determine if short-term exercise reduces falls and fall-related injuries in the elderly.Design: A preplanned meta-analysis of the seven Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT)--independent, randomized, controlled clinical trials that assessed intervention efficacy in reducing falls and frailty in elderly patients. All included an exercise component for 10 to 36 weeks. Fall and injury follow-up was obtained for up to 2 to 4 years.Setting: Two nursing home and five community-dwelling (three health maintenance organizations) sites. Six were group and center based; one was conducted at home.Participants: Numbers of participants ranged from 100 to 1323 per study. Subjects were mostly ambulatory and cognitively intact, with minimum ages of 60 to 75 years, although some studies required additional deficits, such as functionally dependent in two or more activities of daily living, balance deficits or lower extremity weakness, or high risk of falling.Interventions: Exercise components varied across studies in character, duration, frequency, and intensity. Training was performed in one area or more of endurance, flexibility, balance platform, Tai Chi (dynamic balance), and resistance. Several treatment arms included additional nonexercise components, such as behavioral components, medication changes, education, functional activity, or nutritional supplements.Main Outcome Measures: Time to each fall (fall-related injury) by self-report and/or medical records.Results: Using the Andersen-Gill extension of the Cox model that allows multiple fall outcomes per patient, the adjusted fall incidence ratio for treatment arms including general exercise was 0.90 (95% confidence limits [CL], 0.81, 0.99) and for those including balance was 0.83 (95% CL, 0.70, 0.98). No exercise component was significant for injurious falls, but power was low to detect this outcome.Conclusions: Treatments including exercise for elderly adults reduce the risk of falls. [ABSTRACT FROM AUTHOR]- Published
- 1995
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15. Guiding lights for antihypertensive treatment in patients with nondiabetic chronic renal disease: proteinuria and blood pressure levels?
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Mulrow CD, Townsend RR, Mulrow, Cynthia D, and Townsend, Raymond R
- Published
- 2003
16. Evidence based case report: helping an obese patient make informed choices.
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Mulrow CD
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- 1998
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17. Losartan did not differ from captopril for reducing all-cause mortality after acute myocardial infarction.
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Mulrow CD
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- 2003
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18. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration
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Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., Egger, M., Blettner, M., Boffetta, P., Brenner, H., Chêne, G., Cooper, C., Davey-Smith, G., Gagnon, F., Greenland, P., Greenland, S., Infante-Rivard, C., Ioannidis, J., James, A., Jones, G., Ledergerber, B., Little, J., May, M., Moher, D., Momen, H., Morabia, A., Morgenstern, H., Paccaud, F., Röösli, M., Rothenbacher, D., Rothman, K., Sabin, C., Sauerbrei, W., Say, L., Sterne, J., Syddall, H., White, I., Wieland, S., Williams, H., Zou, G. Y., STROBE Initiative, Altman, DG., Blettner, M., Boffetta, P., Brenner, H., Chêne£££Genevie've£££ G., Cooper, C., Davey-Smith, G., von Elm, E., Egger, M., Gagnon, F., Gøtzsche, PC., Greenland, P., Greenland, S., Infante-Rivard, C., Ioannidis, J., James, A., Jones, G., Ledergerber, B., Little, J., May, M., Moher, D., Momen, H., Morabia, A., Morgenstern, H., Mulrow, CD., Paccaud, F., Pocock, SJ., Poole, C., Rö ö sli, M., Rothenbacher, D., Rothman, K., Sabin, C., Sauerbrei, W., Say, L., Schlesselman, JJ., Sterne, J., Syddall, H., Vandenbroucke, JP., White, I., Wieland, S., Williams, H., Zou, GY., Vandenbroucke, J.P., Altman, D.G., Gøtzsche, P.C., Mulrow, C.D., Pocock, S.J., Schlesselman, J.J., Chêne, G., Röösli, M., and Zou, G.Y.
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Research Report ,Biomedical Research ,Cross-sectional study ,Science Policy ,Epidemiology ,Applied psychology ,Public Health and Epidemiology ,Editorial policies (including conflicts of interest) ,610 Medicine & health ,Guidelines as Topic ,Observation ,Strengthening the reporting of observational studies in epidemiology ,computer.software_genre ,Cohort Studies ,Empirical research ,360 Social problems & social services ,Research Methods ,Internal Medicine ,Medicine ,Generalizability theory ,Publishing ,business.industry ,Clinical study design ,General Medicine ,Checklist ,Observational Studies as Topic ,Critical appraisal ,Epidemiologic Studies ,Cross-Sectional Studies ,Research Design ,Case-Control Studies ,Epidemiologic Research Design ,Pediatrics, Perinatology and Child Health ,Surgery ,Observational study ,Data mining ,Psychology ,business ,computer ,reporting of observational studies ,Research Article - Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research., In this explanatory and elaboration document Mattias Egger and colleagues provide the meaning and rationale of each checklist item on the STROBE Statement.
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- 2007
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19. [The PRISMA 2020 statement: an updated guideline for reporting systematic reviewsDeclaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas].
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Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, and Moher D
- Abstract
The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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- 2022
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20. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
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Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, and Moher D
- Subjects
- Humans, Checklist, Publishing
- Abstract
The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews. Full English text available from:www.revespcardiol.org/en., (Copyright © 2021 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2021
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21. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews.
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, and McKenzie JE
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- Data Accuracy, Evidence-Based Medicine, Humans, Medical Writing standards, Meta-Analysis as Topic, Practice Guidelines as Topic, Quality Control, Statistics as Topic, Terminology as Topic, Research Design standards, Systematic Reviews as Topic methods, Systematic Reviews as Topic standards
- Abstract
Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/conflicts-of-interest/ and declare: EL is head of research for the BMJ; MJP is an editorial board member for PLOS Medicine; ACT is an associate editor and MJP, TL, EMW, and DM are editorial board members for the Journal of Clinical Epidemiology; DM and LAS were editors in chief, LS, JMT, and ACT are associate editors, and JG is an editorial board member for Systematic Reviews; none of these authors were involved in the peer review process or decision to publish. TCH has received personal fees from Elsevier outside the submitted work. EMW has received personal fees from the American Journal for Public Health, for which he is the editor for systematic reviews. VW is editor in chief of the Campbell Collaboration which produces systematic reviews and co-convenor of the Campbell and Cochrane equity methods group. DM is chair of the EQUATOR Network, IB is adjunct director of the French EQUATOR Centre and TCH is co-director of the Australasian EQUATOR Centre, which advocate for the use of reporting guidelines to improve the quality of reporting in research articles. JMT received salary from Evidence Partners Inc, creators of DistillerSR software for systematic reviews; Evidence Partners Inc was not involved in the design or outcomes of the statement and the views expressed solely represent those of the author.
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- 2021
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22. Keeping Up With Emerging Evidence in (Almost) Real Time.
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Laine C, Taichman DB, Guallar E, and Mulrow CD
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- COVID-19, Evidence-Based Medicine, Humans, Pandemics, SARS-CoV-2, Betacoronavirus, Coronavirus Infections epidemiology, Periodicals as Topic, Pneumonia, Viral epidemiology, Systematic Reviews as Topic
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- 2020
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23. REPRINT OF: Current Methods of the U.S. Preventive Services Task Force: A Review of the Process.
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Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, and Atkins D
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Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Harris RP, Helfand M, Woolf SH, et al. Current methods of the U.S. Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3S):21-35. The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs). The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence. Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications., (Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2020
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24. Mapping of reporting guidance for systematic reviews and meta-analyses generated a comprehensive item bank for future reporting guidelines.
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Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann T, Mulrow CD, Shamseer L, and Moher D
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- Checklist, Publishing standards, Guidelines as Topic, Meta-Analysis as Topic, Systematic Reviews as Topic
- Abstract
Objectives: The aim of the study was to generate a comprehensive bank of systematic review (SR) reporting items to inform an update of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2009 statement., Methods: We searched the Enhancing the QUAlity and Transparency Of health Research Network library in May 2019 to identify all reporting guidelines for SRs that were published after 2009, regardless of the scope of the guideline. We also conducted a selective review of four guidance manuals for SRs, three tools for assessing the risk of bias in SRs, six meta-research studies evaluating the reporting quality of SRs using a tailored checklist, and five reporting guidelines for other study designs. One author screened and selected sources for inclusion, extracted reporting guidance from sources, and mapped guidance against the PRISMA 2009 checklist items., Results: We included 60 sources providing guidance on reporting of SRs and meta-analyses. From these, we collated a list of 221 unique reporting items. Items were categorized into title (four items), abstract (10 items), introduction (12 items), methods (111 items), results (61 items), discussion (12 items), funding and conflicts of interest (four items), administrative information (three items), and data availability (four items). This exercise generated 175 reporting items that could be added to the guidance in the PRISMA 2009 statement., Conclusion: Generation of a comprehensive item bank through review and mapping of the literature facilitates identification of missing items and those needing modification, which may not otherwise be identified by the guideline development team or from other activities commonly used to develop reporting guidelines., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2020
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25. Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes.
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Cornell JE and Mulrow CD
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- Dietary Supplements
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- 2020
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26. Advancing Personalized Medicine Through Prediction.
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Localio AR, Mulrow CD, and Griswold ME
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- Precision Medicine
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- 2020
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27. Statistical Code to Support the Scientific Story.
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Localio AR, Goodman SN, Meibohm A, Cornell JE, Stack CB, Ross EA, and Mulrow CD
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- Humans, Reproducibility of Results, Software, Periodicals as Topic, Publishing, Statistics as Topic
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- 2018
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28. Annals Understanding Clinical Research: Evaluating the Meaning of a Summary Estimate in a Meta-analysis.
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Cornell JE, Liao JM, Stack CB, and Mulrow CD
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- Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Data Interpretation, Statistical, Health Services Research, Heart Valve Prosthesis Implantation methods, Heart Valve Prosthesis Implantation mortality, Humans, Terminology as Topic, Meta-Analysis as Topic, Research Design
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- 2017
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29. Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia.
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Cornell JE and Mulrow CD
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- Female, Humans, Male, Antibodies, Monoclonal therapeutic use, Anticholesteremic Agents therapeutic use, Hypercholesterolemia drug therapy, Proprotein Convertases immunology, Serine Endopeptidases immunology
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- 2015
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30. PCSK9 Inhibitors: A New Era in Lipid-Lowering Treatment?
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Cainzos-Achirica M, Martin SS, Cornell JE, Mulrow CD, and Guallar E
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- Female, Humans, Male, Antibodies, Monoclonal therapeutic use, Anticholesteremic Agents therapeutic use, Hypercholesterolemia drug therapy, Proprotein Convertases immunology, Serine Endopeptidases immunology
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- 2015
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31. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.
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Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, and Egger M
- Subjects
- Biomedical Research, Case-Control Studies, Checklist, Cohort Studies, Cross-Sectional Studies, Epidemiologic Research Design, Publishing standards, Research Design, Observational Studies as Topic, Research Report standards
- Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
32. Random-effects meta-analysis of inconsistent effects: a time for change.
- Author
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Cornell JE, Mulrow CD, Localio R, Stack CB, Meibohm AR, Guallar E, and Goodman SN
- Subjects
- Confidence Intervals, Data Interpretation, Statistical, Software, Meta-Analysis as Topic
- Abstract
A primary goal of meta-analysis is to improve the estimation of treatment effects by pooling results of similar studies. This article explains how the most widely used method for pooling heterogeneous studies--the Der Simonian-Laird (DL) estimator--can produce biased estimates with falsely high precision. A classic example is presented to show that use of the DL estimator can lead to erroneous conclusions. Particular problems with the DL estimator are discussed, and several alternative methods for summarizing heterogeneous evidence are presented. The authors support replacing universal use of the DL estimator with analyses based on a critical synthesis that recognizes the uncertainty in the evidence,focuses on describing and explaining the probable sources of variation in the evidence, and uses random-effects estimates that provide more accurate confidence limits than the DL estimator.
- Published
- 2014
- Full Text
- View/download PDF
33. Handling of rescue and missing data affects synthesis and interpretation of evidence: the sodium-glucose cotransporter 2 inhibitor example.
- Author
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Stack CB, Localio AR, Griswold ME, Goodman SN, and Mulrow CD
- Subjects
- Humans, Patient Dropouts, Research Design statistics & numerical data, Sensitivity and Specificity, Data Interpretation, Statistical, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Meta-Analysis as Topic, Research Design standards, Sodium-Glucose Transporter 2 Inhibitors
- Abstract
Confidence in evidence summarized in meta-analyses depends on the strength of the underlying studies. This inherent limitation of syntheses appears in the case of a meta-analysis of sodium-glucose cotransporter 2 inhibitors for the treatment of type 2 diabetes because many of the pertinent randomized trials did not handle patient dropout and "rescue" medication properly. Repudiated statistical methods, such as last observation carried forward, and unsophisticated methods for handling postrescue data produce unreliable summary estimates. Future reports of randomized studies and meta-analyses of those studies must focus on posing precise questions about the treatment effect of interest and then implement appropriate statistical methods to account for missing data, patient dropout, and use of rescue medication.
- Published
- 2013
- Full Text
- View/download PDF
34. Toward more uniform conflict disclosures: the updated ICMJE conflict of interest reporting form.
- Author
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Drazen JM, de Leeuw PW, Laine C, Mulrow CD, DeAngelis CD, Frizelle FA, Godlee F, Haug C, Hébert PC, James A, Kotzin S, Marusic A, Reyes H, Rosenberg J, Sahni P, Van Der Weyden MB, and Zhaori G
- Subjects
- Records standards, Conflict of Interest, Disclosure standards, Editorial Policies, Periodicals as Topic standards
- Published
- 2010
- Full Text
- View/download PDF
35. [Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration].
- Author
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Vandenbroucke JP, Von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, and Egger M
- Subjects
- Epidemiologic Studies
- Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
- Published
- 2009
- Full Text
- View/download PDF
36. Diagnostic test accuracy and clinical decision making.
- Author
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Cornell J, Mulrow CD, and Localio AR
- Subjects
- Humans, Meta-Analysis as Topic, Research Design standards, Sensitivity and Specificity, Decision Making, Diagnostic Tests, Routine standards, Review Literature as Topic
- Published
- 2008
- Full Text
- View/download PDF
37. WITHDRAWN: Dieting to reduce body weight for controlling hypertension in adults.
- Author
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Mulrow CD, Chiquette E, Angel L, Grimm R, Cornell J, Summerbell CD, Anagnostelis BB, and Brand M
- Subjects
- Adult, Humans, Diet, Reducing, Hypertension diet therapy
- Abstract
Background: As early as the 1920's, researchers noted a relationship between caloric restriction, weight loss and a decreased incidence of hypertension (Terry 1922, Preble 1923, Bauman 1928, Master 1929). In 1988 a meta-analysis of aggregate data from 12 prospective studies, including 5 randomized controlled trials (RCTs), found that on average each 1 kilogram decrease in body weight in obese hypertensive patients was associated with a 2.4 mm Hg systolic and 1.5 mm Hg diastolic decrease in blood pressure (Staessen 1988). Blood pressure reductions were not dependent upon degree of baseline obesity.This review aims to: 1) update the work of Staessen (Staessen 1988) looking specifically at randomized controlled trials, and 2) assess whether any of the trials assess effects of weight-reducing diets on clinical outcomes such as quality of life, morbidity or mortality., Objectives: Evaluate whether weight-loss diets are more effective than regular diets or other antihypertensive therapies in controlling blood pressure and preventing morbidity and mortality in hypertensive adults., Search Strategy: MEDLINE and The Cochrane Library were searched through November 1997. Trials known to experts in the field were included through June 1998., Selection Criteria: For inclusion in the review, trials were required to meet each of the following criteria: 1) randomized controlled trials with one group assigned to a weight-loss diet and the other group assigned to either normal diet or antihypertensive therapy; 2) ambulatory adults with a mean blood pressure of at least 140 mm Hg systolic and/or 90 mm Hg diastolic; 3) active intervention consisting of a calorie-restricted diet intended to produce weight loss (excluded studies simultaneously implementing multiple lifestyle interventions where the effects of weight loss could not be disaggregated); and 4) outcome measures included weight loss and blood pressure., Data Collection and Analysis: Studies were dual abstracted by two independent reviewers using a standardized form designed specifically for this review. The primary mode of analysis was qualitative; graphs of effect sizes for individual studies were also used., Main Results: Eighteen trials were found. Only one small study of inadequate power reported morbidity and mortality outcomes. None addressed quality of life or general well being issues. In general, participants assigned to weight-reduction groups lost weight compared to control groups.Six trials involving 361 participants assessed a weight-reducing diet versus a normal diet. The data suggested weight loss in the range of 4% to 8% of body weight was associated with a decrease in blood pressure in the range of 3 mm Hg systolic and diastolic. Three trials involving 363 participants assessed a weight-reducing diet versus treatment with antihypertensive medications. These suggested that a stepped-care approach with antihypertensive medications produced greater decreases in blood pressure (in the range of 6/5 mm Hg systolic/diastolic) than did a weight-loss diet. Trials that allowed adjustment of participants' antihypertensive regimens suggested that patients required less intensive antihypertensive drug therapy if they followed a weight-reducing diet. Data was insufficient to determine the relative efficacy of weight-reduction versus changes in sodium or potassium intake or exercise., Authors' Conclusions: Weight-reducing diets in overweight hypertensive persons can affect modest weight loss in the range of 3-9% of body weight and are probably associated with modest blood pressure decreases of roughly 3 mm Hg systolic and diastolic. Weight-reducing diets may decrease dosage requirements of persons taking antihypertensive medications.
- Published
- 2008
- Full Text
- View/download PDF
38. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.
- Author
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Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, and Egger M
- Subjects
- Case-Control Studies, Cohort Studies, Cross-Sectional Studies, Epidemiologic Research Design, Guidelines as Topic, Observation methods, Publishing standards
- Abstract
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalizability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers.This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated web site (http://www.strobe-statement.org) should be helpful resources to improve reporting of observational research.
- Published
- 2007
- Full Text
- View/download PDF
39. Rosiglitazone: a thunderstorm from scarce and fragile data.
- Author
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Mulrow CD, Cornell J, and Localio AR
- Subjects
- Cardiovascular Diseases chemically induced, Diabetes Mellitus, Type 2 drug therapy, Humans, Meta-Analysis as Topic, Research Design standards, Rosiglitazone, Cardiovascular Diseases mortality, Hypoglycemic Agents adverse effects, Myocardial Infarction chemically induced, Thiazolidinediones adverse effects
- Published
- 2007
- Full Text
- View/download PDF
40. Trials that matter: should we routinely measure homocysteine levels and "treat" mild hyperhomocysteinemia?
- Author
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Rosenberg IH and Mulrow CD
- Subjects
- Clinical Trials as Topic, Humans, Research Design, Cardiovascular Diseases prevention & control, Hyperhomocysteinemia complications, Hyperhomocysteinemia therapy, Stroke prevention & control
- Published
- 2006
- Full Text
- View/download PDF
41. Adverse events: the more you search, the more you find.
- Author
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Ioannidis JP, Mulrow CD, and Goodman SN
- Subjects
- Humans, Drug-Related Side Effects and Adverse Reactions, Randomized Controlled Trials as Topic standards, Surveys and Questionnaires standards
- Published
- 2006
- Full Text
- View/download PDF
42. Exorcising ghosts and unwelcome guests.
- Author
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Laine C and Mulrow CD
- Subjects
- Humans, United States, Authorship, Periodicals as Topic standards, Writing standards
- Published
- 2005
- Full Text
- View/download PDF
43. An editorial update: what level of blood pressure control in chronic kidney disease?
- Author
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Levey AS and Mulrow CD
- Subjects
- Disease Progression, Humans, Kidney Diseases physiopathology, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Antihypertensive Agents therapeutic use, Hypertension complications, Hypertension drug therapy, Kidney Diseases complications
- Published
- 2005
- Full Text
- View/download PDF
44. Functional independence after major abdominal surgery in the elderly.
- Author
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Lawrence VA, Hazuda HP, Cornell JE, Pederson T, Bradshaw PT, Mulrow CD, and Page CP
- Subjects
- Aged, Aged, 80 and over, Disability Evaluation, Female, Geriatric Assessment, Humans, Male, Middle Aged, Postoperative Period, Prospective Studies, Abdomen surgery, Activities of Daily Living, Recovery of Function, Surgical Procedures, Operative rehabilitation
- Abstract
Background: Elders undergo approximately 40% of more than 1 million major abdominal operations annually. Yet evidence about recovery to preoperative levels of functional independence is limited. This study details course and predictors of functional recovery after elective major abdominal operations in the elderly., Study Design: This was a prospective cohort of 372 consecutive patients, 60 years old or more, enrolled from surgeons in private practice and two university-affiliated hospitals, assessed preoperatively and postoperatively at 1, 3, and 6 weeks, 3 and 6 months, using self-report and performance-based measures (Activities of Daily Living [ADL], Instrumental Activities of Daily Living [IADL], Medical Outcomes Study Short Form-36 Physical Component and Mental Component Scales [PCS, MCS], Geriatric Depression Scale [GDS], Folstein Mini-Mental State Exam [MMSE], timed walk, functional reach, hand grip strength)., Results: Mean age was 69 +/- 6 years with 56% men, 47% nonHispanic Caucasian, and 42% Mexican American; hospital distribution was 49% private, 51% university-affiliated. Maximum functional declines (95% CI) occurred 1 week postoperatively: ADL, 2.8 points (2.4 to 3.2); IADL, 7.6 points (7 to 8.3); SF-36 PCS, 6.5 points (5.4 to 7.6); Mini-Mental State Exam, 0.5 points (0.2 to 0.7); timed walk, 6.8 seconds (5.2 to 8.4); functional reach, 1.7 inches (1.2 to 2.2); grip strength, 2 kilograms (1.3 to 2.7) (p < 0.001 for all). SF-36 mental component scale and Geriatric Depression Scale scores did not worsen. Mean recovery times were: Mini-Mental State Exam, 3 weeks; timed walk, 6 weeks; ADL, SF-36 PCS, and functional reach, 3 months; and IADL, 6 months. Mean grip strength did not return to preoperative status by 6 months. The incidence of persistent disability at 6 months, compared with preoperative status, was: ADL, 9%; IADL, 19%; PCS, 16%; mental component scale, 17%; timed walk, 39%; functional reach, 58%; and grip strength, 52%. Potentially modifiable independent predictors of ADL and IADL recovery were preoperative physical conditioning and depression plus serious postoperative complications., Conclusions: The clinical course of functional recovery varied across different measures. Protracted disability at 6 months after operation was substantial. Several potentially modifiable factors consistently predicted recovery.
- Published
- 2004
- Full Text
- View/download PDF
45. Newborn hearing screening: recommendations and rationale.
- Author
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Berg AO, Allan JD, Frame PS, Homer CJ, Johnson MS, Klein JD, Lieu TA, Mulrow CD, Orleans CT, Peipert JF, Pender NJ, Siu AL, Teutsch SM, Westhoff C, and Woolf SH
- Subjects
- American Speech-Language-Hearing Association, Attitude of Health Personnel, Hearing Loss, Sensorineural classification, Hearing Loss, Sensorineural epidemiology, Humans, Infant, Newborn, Neonatal Screening legislation & jurisprudence, Severity of Illness Index, United States epidemiology, Hearing Loss, Sensorineural diagnosis, Neonatal Screening methods
- Published
- 2002
46. Screening for chlamydia infection: recommendations and rationale. U.S. Preventive Services Task Force.
- Author
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Berg AO, Allan JD, Frame PS, Homer CJ, Lieu TA, Mulrow CD, Orleans CT, Peipert JF, Pender NJ, Sox HC Jr, Teusch SM, Westhoff C, and Woolf SH
- Subjects
- Chlamydia Infections epidemiology, Chlamydia Infections etiology, Chlamydia Infections prevention & control, Evidence-Based Medicine, Health Policy, Humans, Mass Screening standards, Preventive Medicine standards, Primary Prevention methods, Primary Prevention standards, Reproducibility of Results, Research Design standards, Risk Factors, Sensitivity and Specificity, United States epidemiology, Chlamydia Infections diagnosis, Mass Screening methods
- Published
- 2002
47. Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force.
- Author
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Eden KB, Orleans CT, Mulrow CD, Pender NJ, and Teutsch SM
- Subjects
- Adult, Controlled Clinical Trials as Topic, Female, Humans, Male, Office Visits, Time Factors, Counseling, Exercise, Health Behavior, Primary Health Care
- Abstract
Purpose: To determine whether counseling adults in primary care settings improves and maintains physical activity levels., Data Sources: The Cochrane Database of Systematic Reviews and Registry of Controlled Trials and the MEDLINE, HealthStar, and Best Evidence databases were searched for papers published from 1994 to March 2002., Study Selection: Controlled trials, case-control studies, and observational studies that examined counseling interventions aimed at increasing physical activity in general primary care populations were reviewed. The researchers included trials in which 1) a patient's primary care clinician performed some of the counseling intervention; 2) behavioral outcomes (physical activity) were reported; and 3) the study was of "good" or "fair" quality, according to criteria developed by the U.S. Preventive Services Task Force., Data Extraction: Data were abstracted on design and execution, quality, providers, patients, setting, counseling intervention, and self-reported physical activity at follow-up., Data Synthesis: Eight trials involving 9054 adults met the inclusion criteria. Among six controlled trials with a usual care control group, the effects of counseling on physical activity were mixed. Because most studies had at least one methodologic limitation, it was difficult to rigorously assess the efficacy of the interventions. More research is needed to clarify the effect, benefits, and potential harms of counseling patients in primary care settings to increase physical activity., Conclusion: Evidence is inconclusive that counseling adults in the primary care setting to increase physical activity is effective.
- Published
- 2002
- Full Text
- View/download PDF
48. St John's wort and depression.
- Author
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Linde K, Melchart D, Mulrow CD, and Berner M
- Subjects
- Humans, Depressive Disorder, Major drug therapy, Hypericum, Phytotherapy, Plant Preparations therapeutic use
- Published
- 2002
49. Measuring subclinical disability in older mexican americans.
- Author
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Hazuda HP, Gerety MB, Lee S, Mulrow CD, and Lichtenstein MJ
- Subjects
- Aged, Female, Humans, Longitudinal Studies, Male, Texas, Activities of Daily Living psychology, Adaptation, Psychological, Disability Evaluation, Geriatric Assessment, Mexican Americans psychology
- Abstract
Objective: The purpose of this study was to develop a comprehensive list of adaptive strategies to prevent disability and use this information to devise a preliminary measure of subclinical disability (state of sustained independence in the presence of latent or manifest functional limitations) suitable for older Mexican Americans., Method: Semistructured interviews were conducted with 24 community-dwelling Mexican American elders (> or =65 years old) to elicit information about adaptations in performance of daily living tasks (eg, walking, dressing, and shopping) that may indicate presence of subclinical disability. This information was used to construct a quantitative self-report measure of subclinical disability administered to 207 older Mexican Americans. Item and factor analyses were performed to reduce the number of items and establish their underlying structure. Construct and discriminant validity of the reduced instrument was determined., Results: A framework comprised of nine categories of daily living tasks, three functional levels, and five adaptation types was generated from the qualitative data. The initial 133-item measure (named the ADAPT) was reduced to a 44-item scale with three subscales (physical, household, and social). ADAPT scores correlated significantly in the expected direction with standard functional status measures, but the shared variance was modest, indicating that the ADAPT captured substantial, unique variance. Mean ADAPT scores differed significantly and were monotonically lower across subgroups classified as independent, subclinically disabled, and disabled, respectively., Conclusions: The ADAPT seems to have construct and discriminant validity as a measure of subclinical disability. Additional research is required to determine sensitivity to change and clinically significant cut points for varying risk of frank disability.
- Published
- 2002
- Full Text
- View/download PDF
50. Welcome, PIER, a new Physicians' Information and Education Resource.
- Author
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Badgett RG and Mulrow CD
- Subjects
- Education, Medical, Continuing, Evidence-Based Medicine, Humans, Societies, Medical, United States, Internal Medicine, Medical Informatics Applications
- Published
- 2002
- Full Text
- View/download PDF
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