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Users' Guides to the Medical Literature: Title and subTitle BreakV. How to Use an Article About Prognosis FREE

Andreas Laupacis, MD, MSc; George Wells, MSc, PhD; W. Scott Richardson, MD; Peter Tugwell, MD, MSc; Gordon H. Guyatt, MD, MSc; George Browman, MD, MSc; Deborah Cook, MD, MSc; Hertzel Gerstein, MD, MSc; Brian Haynes, MD, MSc, PhD; Robert Hayward, MD, MPH; Mitchell Levine, MD, MSc; Jim Nishikawa, MD; David L. Sackett, MD, MSc; Patrick Brill-Edwards, MD; Michael Farkouh, MD; Anne Holbrook, MD, PharmD, MSc; Roman Jaeschke, MD, MSc; Hui Lee, MD, MSc; Stephane Sauve, MD, MSc; Virginia Moyer, MD, MPH; David Naylor, MD, DPhil; Andrew Oxman, MD, MSc, FACPM; John Philbrick, MD; Jack Sinclair, MD; Brian L. Strom, MD, MPH; Sean Tunis, MD, MSc; John Williams, Jr, MD, MHS; Mark Wilson, MD, MPH
[+] Author Affiliations

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(3):234-237. doi:10.1001/jama.1994.03520030076032
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CLINICAL SCENARIO  You are about to see a 76-year-old retired schoolteacher for the second time. You first saw her in the clinic a month ago because of cognitive problems. Your evaluation at that time included a Standardized Mini-Mental State Examination,1 on which she scored 18 out of a possible 30 points, and a physical examination that was normal including no focal neurological signs. You arranged investigations for the treatable causes of dementia that were negative, and you thus feel she has probable Alzheimer's disease.The patient has lived with her son since her husband died 6 years ago. Her son thinks that she first developed significant problems with her memory about 3 years ago. However, she has become increasingly agitated and paranoid during the last year. She has refused to allow him to look after her financial affairs, despite the fact that she owns three pieces of property and

REFERENCES

Molloy DW, Alemayehu E, Roberts R.  Reliability of a standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. Am J Psychiatry . 1991;;148:102-105.
Walsh JS, Welch G, Larson EB.  Survival of outpatients with Alzheimer-type dementia. Ann Intern Med . 1990;;113:429-434.
Levine M, Walter S, Lee H, et al, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, IV: how to use an article about harm. JAMA . 1994;;271:1615-1619.
Dawber TR, Kaunel WB, Lyell LP.  An approach to longitudinal studies in a community: the Framingham Study. Ann N Y Acad Sci . 1963;;107:539-556.
Bennett JC, for the Board on Health Sciences Policy of the Institute of Medicine.  Inclusion of women in clinical trials: policies for population subgroups. N Engl J Med . 1993;;329:288-292.
Ellenberg JH, Nelson KB.  Sample selection and the natural history of disease: studies of febrile seizures. JAMA . 1980;;243:1337-1340.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 4th ed. Washington DC; 1994;:139-143.
Early Breast Cancer Trialists' Collaborative Group.  Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31000 recurrences and 24000 deaths among 75000 women. Lancet . 1992;; 339:1-15.
Wolf PA, Dawber TR, Thomas HE, Kannel WB.  Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham Study. Neurology . 1978;;28:973-977.
Pincus T, Brooks RH, Callahan LF.  Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med . 1994;;120:26-34.
Berger CJ, Murabito JM, Evans JC, Anderson KM, Levy D.  Prognosis after first myocardial infarction: comparison of Q-wave and non-Q-wave myocardial infarction in the Framingham Heart Study. JAMA . 1992;;228:1545-1551.
Katz MH, Hauck WW.  Proportional hazards (Cox) regression. J Gen Intern Med . 1993;;8:702-711.
ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.  Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet . 1988;;2:349-360.
Dorey F, Amstutz H.  The validity of survivorship analysis in total joint arthroplasty. J Bone Joint Surg Am . 1989;;71:544-548.
Laupacis A, Albers G, Dunn M, Feinberg W.  Antithrombotic therapy in atrial fibrillation. Chest . 1992;;102:426S-433S.
Kopecky SL.  The natural history of lone atrial fibrillation: a population-based study over three decades. N Engl J Med . 1987;;317:669-674.
Meador CK.  The art and science of nondisease. N Engl J Med . 1965;;272:92.
Stern Y, Mayeux R, Hauser WA, Bush T.  Predictors of disease course in patients with probable Alzheimer's disease. Neurology . 1987;;37:1649-1653.
Drachman DA, O'Donnell BF, Lew RA, Swearer JM.  The prognosis in Alzheimer's disease: 'how far' rather than 'how fast' best predicts the course. Arch Neurol . 1990;;47:851-856.

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Molloy DW, Alemayehu E, Roberts R.  Reliability of a standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. Am J Psychiatry . 1991;;148:102-105.
Walsh JS, Welch G, Larson EB.  Survival of outpatients with Alzheimer-type dementia. Ann Intern Med . 1990;;113:429-434.
Levine M, Walter S, Lee H, et al, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, IV: how to use an article about harm. JAMA . 1994;;271:1615-1619.
Dawber TR, Kaunel WB, Lyell LP.  An approach to longitudinal studies in a community: the Framingham Study. Ann N Y Acad Sci . 1963;;107:539-556.
Bennett JC, for the Board on Health Sciences Policy of the Institute of Medicine.  Inclusion of women in clinical trials: policies for population subgroups. N Engl J Med . 1993;;329:288-292.
Ellenberg JH, Nelson KB.  Sample selection and the natural history of disease: studies of febrile seizures. JAMA . 1980;;243:1337-1340.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 4th ed. Washington DC; 1994;:139-143.
Early Breast Cancer Trialists' Collaborative Group.  Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31000 recurrences and 24000 deaths among 75000 women. Lancet . 1992;; 339:1-15.
Wolf PA, Dawber TR, Thomas HE, Kannel WB.  Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham Study. Neurology . 1978;;28:973-977.
Pincus T, Brooks RH, Callahan LF.  Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med . 1994;;120:26-34.
Berger CJ, Murabito JM, Evans JC, Anderson KM, Levy D.  Prognosis after first myocardial infarction: comparison of Q-wave and non-Q-wave myocardial infarction in the Framingham Heart Study. JAMA . 1992;;228:1545-1551.
Katz MH, Hauck WW.  Proportional hazards (Cox) regression. J Gen Intern Med . 1993;;8:702-711.
ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.  Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet . 1988;;2:349-360.
Dorey F, Amstutz H.  The validity of survivorship analysis in total joint arthroplasty. J Bone Joint Surg Am . 1989;;71:544-548.
Laupacis A, Albers G, Dunn M, Feinberg W.  Antithrombotic therapy in atrial fibrillation. Chest . 1992;;102:426S-433S.
Kopecky SL.  The natural history of lone atrial fibrillation: a population-based study over three decades. N Engl J Med . 1987;;317:669-674.
Meador CK.  The art and science of nondisease. N Engl J Med . 1965;;272:92.
Stern Y, Mayeux R, Hauser WA, Bush T.  Predictors of disease course in patients with probable Alzheimer's disease. Neurology . 1987;;37:1649-1653.
Drachman DA, O'Donnell BF, Lew RA, Swearer JM.  The prognosis in Alzheimer's disease: 'how far' rather than 'how fast' best predicts the course. Arch Neurol . 1990;;47:851-856.
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