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Users' Guides to the Medical Literature: Title and subTitle BreakVI. How to Use an Overview FREE

Andrew D. Oxman, MD, MSc; Deborah J. Cook, MD, MSc; Gordon H. Guyatt, MD, MSc; Eric Bass, MD, MPH; Patrick Brill-Edwards, MD; George Browman, MD, MSc; Allan Detsky, MD, PhD; Michael Farkouh, MD; Hertzei Gerstein, MD, MSc; Ted Haines, MD, MSc; Brian Haynes, MD, MSc; Robert Hayward, MD, MPH; Anne Holbrook, MD, PharmD, MSc; Roman Jaeschke, MD, MSc; Elizabeth Juniper, MCSP, MSc; Andreas Laupacis, MD, MSc; Hui Lee, MD, MSc; Mitchell Levine, MD, MSc; Virginia Moyer, MD, MPH; David Naylor, MD, DPhil; Jim Nishikawa, MD; Ameen Patel, MD; John Philbrick, MD; Scott Richardson, MD; Stephane Sauve, MD, MSc; David Sacked, MD, MSc; Jack Sinclair, MD; Brian Strom, MD, MPH; K. S. Trout, FRCE; Sean Tunis, MD, MSc; Stephen Walter, PhD; John Williams, Jr, MD, MHS; Mark Wilson, MD, MPH
[+] Author Affiliations

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).

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

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


JAMA. 1994;272(17):1367-1371. doi:10.1001/jama.1994.03520170077040
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CLINICAL SCENARIO  A 55-year-old man had his serum cholesterol level measured at a shopping mall 2 months ago. His cholesterol level was elevated and he comes to you, his primary care physician, for advice. He does not smoke, is not obese, and does not have hypertension, diabetes mellitus, or any first-order relatives with premature coronary heart disease (CHD). You repeat his cholesterol test and schedule a follow-up appointment. The test confirms an elevated cholesterol level (7.9 mmol/L [305 mg/dL]), but before deciding on a treatment recommendation, you elect to find out just how big a reduction in the risk of CHD this patient could expect from a cholesterollowering diet or drug therapy.

THE SEARCH  There are a number of cholesterol-lowering trials, and instead of trying to find and review all of the original studies yourself, you use Grateful Med to find a recent overview. On the first subject line you

REFERENCES

Davey Smith G, Song F, Sheldon TA.  Cholesterol lowering and mortality: the importance of considering initial level of risk. BMJ . 1993;;306:1367-1373.
Silberberg JS, Henry DA.  The benefits of reducing cholesterol levels: the need to distinguish primary from secondary prevention, I: a meta-analysis of cholesterol-lowering trials. Med J Aust . 1991;; 155:665-666, 669-670.
Oxman AD, Sackett DL, Guyatt GH, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, I: how to get started. JAMA . 1993;;270:2093-2095.
L'Abbe KA, Detsky AS, O'Rourke K.  Meta-analysis in clinical research. Ann Intern Med . 1987;;107: 224-233.
Sacks HS, Berries J, Reitman D, Arcona-Berk VA, Chalmers TC.  Meta-analyses of randomized controlled trials. N Engl J Med . 1987;;316:450-455.
Oxman AD, Guyatt GH.  Guidelines for reading literature reviews. Can Med Assoc J . 1988;;138:697-703.
Mulrow CD.  The medical review article: state of the science. Ann Intern Med . 1987;;106:485-488.
Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC.  A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts: treatments for myocardial infarction. JAMA . 1992;;268:240-248.
Cochrane AL.  1931-1971: a critical review, with particular reference to the medical profession.  In: Medicines for the Year 2000 . London, England: Office of Health Economics; 1979;:2-12.
The Cochrane Collaboration . Oxford, England: UK Cochrane Centre, National Health Service Research and Development Programme; 1994;. Brochure.
Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, eds. Cochrane Pregnancy and Childbirth Database [derived from the Cochrane Database of Systematic Reviews], Cochrane Updates on Disk, Update Software . Oxford, England: UK Cochrane Centre; 1993;: disk issue 2.
Chalmers TC, Berrier J, Sacks HS, et al.  Meta-analysis of clinical trials as a scientific discipline, II: replicate variability and comparison of studies that agree and disagree. Stat Med . 1987;;6:733-744.
Gøtzsche PC.  Reference bias in reports of drug trials. BMJ . 1987;;295:654-656.
Ravnskov U.  Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome. BMJ . 1992;;305:15-19.
Cook DJ, Guyatt GH, Ryan G, et al.  Should unpublished data be included in meta-analyses? current convictions and controversies. JAMA . 1993;; 269:2749-2753.
Dickersin K.  The existence of publication bias and risk factors for its occurrence. JAMA . 1990;; 263:1385-1389.
Dickersin K, Min Y-I, Meinert CL.  Factors influencing publication of research results: follow-up of applications submitted to two institutional review boards. JAMA . 1992;;267:374-378.
Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR.  Publication bias in clinical research. Lancet . 1991;;337:867-872.
Dickersin K, Min Y-I.  NIH clinical trials and publication bias. Online J Curr Clin Trials [serial online] . (April 28) , 1993;;50.
Begg CB, Berlin JA.  Publication bias: a problem in interpreting medical data. J R Stat Soc . 1988;;151:445-463.
Williamson JW, Goldschmidt PG, Colton T.  The quality of medical literature: analysis of validation assessments.  In: Bailar JC, Mosteller F, eds. Medical Uses of Statistics . Waltham, Mass: NEJM Books; 1986;:370-391.
Horwitz RI.  Complexity and contradiction in clinical trial research. Am J Med . 1987;;82:498-510.
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbe A.  Incorporating variations in the quality of individual randomized trials into meta-analysis. J Clin Epidemiol . 1992;;45:255-265.
Chalmers TC, Celano P, Sacks HS, Smith H.  Bias in treatment assignment in controlled trials. N Engl J Med . 1983;;309:1358-1361.
Peto R.  Why do we need systematic overviews of randomized trials? Stat Med . 1987;;6:223-240.
Yusuf S, Wiftes J, Probstfield J, Tyroler HA.  Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. JAMA . 1991;;266:93-98.
Oxman AD, Guyatt GH.  A consumer's guide to subgroup analysis. Ann Intern Med . 1992;;116:78-84.
Glass GV, McGaw B, Smith ML. Meta-analysis in Social Research . Newbury Park, Calif: Sage; 1981;:18-20.
Cooper RM, Rosenthal R.  Statistical versus traditional procedures for summarizing research findings. Psychol Bull . 1980;;87:442-449.
Guyatt GH, Sackett DL, Cook DJ, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, II: how to use an article about therapy or prevention, B: what were the results and will they help me in caring for my patients? JAMA . 1994;;271:59-63.
Jaeschke R, Guyatt GH, Sackett DL, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, III: how to use an article about a diagnostic test, B: what are the results and will they help me in caring for my patients? JAMA . 1994;;271:703-707.
Laupacis A, Sackett DL, Roberts RS.  An assessment of clinically useful measures of the consequences of treatment. N Engl J Med . 1988;;318: 1728-1733.
Rosenthal R. Meta-analytic Procedures for Social Research . 2nd ed. Newbury Park, Calif: Sage; 1991;.
Smith K, Cook DJ, Guyatt GH, Mudhaven J, Oxman AD.  Respiratory muscle training in chronic airflow limitation: a meta-analysis. Am Rev Respir Dis . 1992;;145:533-539.
Yusuf S, Peto R, Lewis J, Collins R, Sleight P.  Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis . 1985;;27:335-371.
Muldoon MF, Manuck SB, Matthews KA.  Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ . 1990;;301:309-314.
Davey Smith G, Pekkanen J.  Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;;304:431-434.
Law MR, Thompson SG, Wald NJ.  Assessing possible hazards of reducing serum cholesterol. BMJ . 1994;;308:373-379.
Law MR, Wald NJ, Thompson SG.  By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ . 1994;;308:367-373.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Davey Smith G, Song F, Sheldon TA.  Cholesterol lowering and mortality: the importance of considering initial level of risk. BMJ . 1993;;306:1367-1373.
Silberberg JS, Henry DA.  The benefits of reducing cholesterol levels: the need to distinguish primary from secondary prevention, I: a meta-analysis of cholesterol-lowering trials. Med J Aust . 1991;; 155:665-666, 669-670.
Oxman AD, Sackett DL, Guyatt GH, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, I: how to get started. JAMA . 1993;;270:2093-2095.
L'Abbe KA, Detsky AS, O'Rourke K.  Meta-analysis in clinical research. Ann Intern Med . 1987;;107: 224-233.
Sacks HS, Berries J, Reitman D, Arcona-Berk VA, Chalmers TC.  Meta-analyses of randomized controlled trials. N Engl J Med . 1987;;316:450-455.
Oxman AD, Guyatt GH.  Guidelines for reading literature reviews. Can Med Assoc J . 1988;;138:697-703.
Mulrow CD.  The medical review article: state of the science. Ann Intern Med . 1987;;106:485-488.
Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC.  A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts: treatments for myocardial infarction. JAMA . 1992;;268:240-248.
Cochrane AL.  1931-1971: a critical review, with particular reference to the medical profession.  In: Medicines for the Year 2000 . London, England: Office of Health Economics; 1979;:2-12.
The Cochrane Collaboration . Oxford, England: UK Cochrane Centre, National Health Service Research and Development Programme; 1994;. Brochure.
Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, eds. Cochrane Pregnancy and Childbirth Database [derived from the Cochrane Database of Systematic Reviews], Cochrane Updates on Disk, Update Software . Oxford, England: UK Cochrane Centre; 1993;: disk issue 2.
Chalmers TC, Berrier J, Sacks HS, et al.  Meta-analysis of clinical trials as a scientific discipline, II: replicate variability and comparison of studies that agree and disagree. Stat Med . 1987;;6:733-744.
Gøtzsche PC.  Reference bias in reports of drug trials. BMJ . 1987;;295:654-656.
Ravnskov U.  Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome. BMJ . 1992;;305:15-19.
Cook DJ, Guyatt GH, Ryan G, et al.  Should unpublished data be included in meta-analyses? current convictions and controversies. JAMA . 1993;; 269:2749-2753.
Dickersin K.  The existence of publication bias and risk factors for its occurrence. JAMA . 1990;; 263:1385-1389.
Dickersin K, Min Y-I, Meinert CL.  Factors influencing publication of research results: follow-up of applications submitted to two institutional review boards. JAMA . 1992;;267:374-378.
Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR.  Publication bias in clinical research. Lancet . 1991;;337:867-872.
Dickersin K, Min Y-I.  NIH clinical trials and publication bias. Online J Curr Clin Trials [serial online] . (April 28) , 1993;;50.
Begg CB, Berlin JA.  Publication bias: a problem in interpreting medical data. J R Stat Soc . 1988;;151:445-463.
Williamson JW, Goldschmidt PG, Colton T.  The quality of medical literature: analysis of validation assessments.  In: Bailar JC, Mosteller F, eds. Medical Uses of Statistics . Waltham, Mass: NEJM Books; 1986;:370-391.
Horwitz RI.  Complexity and contradiction in clinical trial research. Am J Med . 1987;;82:498-510.
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbe A.  Incorporating variations in the quality of individual randomized trials into meta-analysis. J Clin Epidemiol . 1992;;45:255-265.
Chalmers TC, Celano P, Sacks HS, Smith H.  Bias in treatment assignment in controlled trials. N Engl J Med . 1983;;309:1358-1361.
Peto R.  Why do we need systematic overviews of randomized trials? Stat Med . 1987;;6:223-240.
Yusuf S, Wiftes J, Probstfield J, Tyroler HA.  Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. JAMA . 1991;;266:93-98.
Oxman AD, Guyatt GH.  A consumer's guide to subgroup analysis. Ann Intern Med . 1992;;116:78-84.
Glass GV, McGaw B, Smith ML. Meta-analysis in Social Research . Newbury Park, Calif: Sage; 1981;:18-20.
Cooper RM, Rosenthal R.  Statistical versus traditional procedures for summarizing research findings. Psychol Bull . 1980;;87:442-449.
Guyatt GH, Sackett DL, Cook DJ, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, II: how to use an article about therapy or prevention, B: what were the results and will they help me in caring for my patients? JAMA . 1994;;271:59-63.
Jaeschke R, Guyatt GH, Sackett DL, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, III: how to use an article about a diagnostic test, B: what are the results and will they help me in caring for my patients? JAMA . 1994;;271:703-707.
Laupacis A, Sackett DL, Roberts RS.  An assessment of clinically useful measures of the consequences of treatment. N Engl J Med . 1988;;318: 1728-1733.
Rosenthal R. Meta-analytic Procedures for Social Research . 2nd ed. Newbury Park, Calif: Sage; 1991;.
Smith K, Cook DJ, Guyatt GH, Mudhaven J, Oxman AD.  Respiratory muscle training in chronic airflow limitation: a meta-analysis. Am Rev Respir Dis . 1992;;145:533-539.
Yusuf S, Peto R, Lewis J, Collins R, Sleight P.  Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis . 1985;;27:335-371.
Muldoon MF, Manuck SB, Matthews KA.  Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ . 1990;;301:309-314.
Davey Smith G, Pekkanen J.  Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;;304:431-434.
Law MR, Thompson SG, Wald NJ.  Assessing possible hazards of reducing serum cholesterol. BMJ . 1994;;308:373-379.
Law MR, Wald NJ, Thompson SG.  By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ . 1994;;308:367-373.
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