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April 26, 1995, Vol 273, No. 16 >
ARTICLE | April 26, 1995

Users' Guides to the Medical Literature: Title and subTitle BreakVII. How to Use a Clinical Decision Analysis A. Are the Results of the Study Valid? FREE

W. Scott Richardson, MD; Allan S. Detsky, MD, PhD
[+] 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). The following members contributed to this article: Gordon Guyatt, MD, MSc (chair); Deborah Cook, MD, MSc; Hertzel Gerstein, MD, MSc; Robert Hayward, MD, MPH; Anne Holbrook, MD, PharmD, MSc; Roman Jaeschke, MD, MSc; Elizabeth Juniper, MCSP, MSc; Mitchell Levine, MD, MSc; David Naylor, MD, DPhil; Andrew Oxman, MD, MSc, FACPM; David Sackett, MD, MSc; Sean Tunis, MD, MSc; Stephen Walter, PhD; John Williams, Jr, MD, MHS; and Mark Wilson, MD, MPH.

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


JAMA. 1995;273(16):1292-1295. doi:10.1001/jama.1995.03520400062046
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References

CLINICAL SCENARIO  You are the attending physician on an inpatient service where a 51-year-old man is admitted with congestive heart failure of recent onset. You find he has a dilated cardiomyopathy, the cause of which remains unknown after a thorough evaluation. He is in sinus rhythm. The team's resident asks you whether the patient should be anticoagulated with warfarin, enough to keep his international normalized ratio from 2.0 to 3.0, in order to prevent systemic emboli, even though his echocardiogram does not show left ventricular thrombus. You are not sure about the evidence concerning this issue, so you admit your shared knowledge gap and resolve to search together for the relevant information.

THE SEARCH  In the hospital's library, the two of you search the MEDLINE system us

REFERENCES

1 +
Falk RH.  A plea for a clinical trial of anticoagulation in dilated cardiomyopathy. Am J Cardiol . 1990;;65:914-915.
2 +
Dec GW, Fuster V.  Idiopathic dilated cardiomyopathy. N Engl J Med . 1994;;331:1564-1575.
3 +
Baker DW, Wright RF.  Management of heart failure, IV: anticoagulation for patients with heart failure due to left ventricular systolic dysfunction. JAMA . 1994;;272:1614-1618.
4 +
Tsevat J, Eckman MH, McNutt RA, Pauker SG.  Warfarin for dilated cardiomyopathy: a bloody tough pill to swallow? Med Decis Making . 1989;;9:162-169.
5 +
Keeney RL.  Decision analysis: an overview. Operations Res . 1982;;30:803-838.
6 +
Eckman MH, Levine HJ, Pauker SG.  Decision analytic and cost-effectiveness issues concerning anticoagulant prophylaxis in heart disease. Chest . 1992;;102( (suppl 4) ):538S-549S.
7 +
Kassirer JP, Moskowitz AJ, Lau J, Pauker SG.  Decision analysis: a progress report. Ann Intern Med . 1987;;106:275-291.
8 +
Eddy DM.  Designing a practice policy: standards, guidelines, and options. JAMA . 1990;;263:3077,3081, 3084.
9 +
Wong JB, Salem DN, Pauker SG.  You're never too old. N Engl J Med . 1993;;328:971-975.
10 +
Krahn MD, Mahoney JE, Eckman MH, Trachtenberg J, Pauker SG, Detsky AS.  Screening for prostate cancer: a decision analytic view. JAMA . 1994;;272:773-780.
11 +
Krahn MD, Naylor CD, Basinski AS, et al.  Comparison of an aggressive (U.S.) and a less aggressive (Canadian) policy for cholesterol screening and treatment. Ann Intern Med . 1991;;115:248-255.
12 +
Goel V.  Decision analysis: applications and limitations. Can Med Assoc J . 1992;;147:413-417.
13 +
Weinstein MC, Fineberg HV, et al. Clinical Decision Analysis . Philadelphia, Pa: WB Saunders; 1980;.
14 +
Sox HC, Blatt MA, Higgins MC, Marton KI. Medical Decision Making . Boston, Mass: Butterworth-Heinemann; 1988;.
15 +
Barza M, Pauker SG.  The decision to biopsy, treat, or wait in suspected herpes encephalitis. Ann Intern Med . 1980;;92:641-649.
16 +
Katz DA, Littenberg B, Cronenwett JL.  Management of small abdominal aortic aneurysms: early surgery vs watchful waiting. JAMA . 1992;;268:2678-2686.
17 +
Oxman AD, Cook DJ, Guyatt GH, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VI: how to use an overview. JAMA . 1994;;272;1367-1371.
18 +
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, A: are the results of the study valid? JAMA . 1993;;270:2598-2601.
19 +
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.
20 +
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, A: are the results of the study valid? JAMA . 1994;;271:389-391.
21 +
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.
22 +
Levine MS, Walter SS, Lee HN, Haines T, Holbrook A, Moyer V, 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.
23 +
Laupacis A, Wells G, Richardson WS, Tugwell P, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, V: how to use an article about prognosis. JAMA . 1994;;272: 234-237.
24 +
Llewellyn-Thomas H, Sutherland HJ, Tibshirani R, et al.  The measurement of patient values in medicine. Med Decis Making . 1982;;2:449-462.
25 +
Dolan JG, Isselhardt BJ, Cappuccio JD.  The analytic hierarchy process in medical decision making: a tutorial. Med Decis Making . 1989;;9:40-50.
26 +
Disch DL, Greenberg ML, Holzberger PT, et al.  Managing chronic atrial fibrillation: a Markov decision analysis comparing warfarin, quinidine, and low-dose amiodarone. Ann Intern Med . 1994;;120: 449-457.
27 +
Buchbinder R, Detsky AS.  Management of suspected giant cell arteritis: a decision analysis. J Rheumatol . 1992;;19:1220-1228.

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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

1 +
Falk RH.  A plea for a clinical trial of anticoagulation in dilated cardiomyopathy. Am J Cardiol . 1990;;65:914-915.
2 +
Dec GW, Fuster V.  Idiopathic dilated cardiomyopathy. N Engl J Med . 1994;;331:1564-1575.
3 +
Baker DW, Wright RF.  Management of heart failure, IV: anticoagulation for patients with heart failure due to left ventricular systolic dysfunction. JAMA . 1994;;272:1614-1618.
4 +
Tsevat J, Eckman MH, McNutt RA, Pauker SG.  Warfarin for dilated cardiomyopathy: a bloody tough pill to swallow? Med Decis Making . 1989;;9:162-169.
5 +
Keeney RL.  Decision analysis: an overview. Operations Res . 1982;;30:803-838.
6 +
Eckman MH, Levine HJ, Pauker SG.  Decision analytic and cost-effectiveness issues concerning anticoagulant prophylaxis in heart disease. Chest . 1992;;102( (suppl 4) ):538S-549S.
7 +
Kassirer JP, Moskowitz AJ, Lau J, Pauker SG.  Decision analysis: a progress report. Ann Intern Med . 1987;;106:275-291.
8 +
Eddy DM.  Designing a practice policy: standards, guidelines, and options. JAMA . 1990;;263:3077,3081, 3084.
9 +
Wong JB, Salem DN, Pauker SG.  You're never too old. N Engl J Med . 1993;;328:971-975.
10 +
Krahn MD, Mahoney JE, Eckman MH, Trachtenberg J, Pauker SG, Detsky AS.  Screening for prostate cancer: a decision analytic view. JAMA . 1994;;272:773-780.
11 +
Krahn MD, Naylor CD, Basinski AS, et al.  Comparison of an aggressive (U.S.) and a less aggressive (Canadian) policy for cholesterol screening and treatment. Ann Intern Med . 1991;;115:248-255.
12 +
Goel V.  Decision analysis: applications and limitations. Can Med Assoc J . 1992;;147:413-417.
13 +
Weinstein MC, Fineberg HV, et al. Clinical Decision Analysis . Philadelphia, Pa: WB Saunders; 1980;.
14 +
Sox HC, Blatt MA, Higgins MC, Marton KI. Medical Decision Making . Boston, Mass: Butterworth-Heinemann; 1988;.
15 +
Barza M, Pauker SG.  The decision to biopsy, treat, or wait in suspected herpes encephalitis. Ann Intern Med . 1980;;92:641-649.
16 +
Katz DA, Littenberg B, Cronenwett JL.  Management of small abdominal aortic aneurysms: early surgery vs watchful waiting. JAMA . 1992;;268:2678-2686.
17 +
Oxman AD, Cook DJ, Guyatt GH, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VI: how to use an overview. JAMA . 1994;;272;1367-1371.
18 +
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, A: are the results of the study valid? JAMA . 1993;;270:2598-2601.
19 +
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.
20 +
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, A: are the results of the study valid? JAMA . 1994;;271:389-391.
21 +
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.
22 +
Levine MS, Walter SS, Lee HN, Haines T, Holbrook A, Moyer V, 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.
23 +
Laupacis A, Wells G, Richardson WS, Tugwell P, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, V: how to use an article about prognosis. JAMA . 1994;;272: 234-237.
24 +
Llewellyn-Thomas H, Sutherland HJ, Tibshirani R, et al.  The measurement of patient values in medicine. Med Decis Making . 1982;;2:449-462.
25 +
Dolan JG, Isselhardt BJ, Cappuccio JD.  The analytic hierarchy process in medical decision making: a tutorial. Med Decis Making . 1989;;9:40-50.
26 +
Disch DL, Greenberg ML, Holzberger PT, et al.  Managing chronic atrial fibrillation: a Markov decision analysis comparing warfarin, quinidine, and low-dose amiodarone. Ann Intern Med . 1994;;120: 449-457.
27 +
Buchbinder R, Detsky AS.  Management of suspected giant cell arteritis: a decision analysis. J Rheumatol . 1992;;19:1220-1228.

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