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May 21, 1997, Vol 277, No. 19 >
ARTICLE | May 21, 1997

Users' Guides to the Medical Literature: Title and subTitle BreakXIII. How to Use an Article on Economic Analysis of Clinical Practice A. Are the Results of the Study Valid? FREE

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

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

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

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


JAMA. 1997;277(19):1552-1557. doi:10.1001/jama.1997.03540430064035
Text Size: A A A
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Article
References

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

REFERENCES

1 +
The GUSTO Investigators.  An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction . N Engl J Med . 1993;;329:673-682.
2 +
Mark DB, Hlatky MA, Califf RM, et al.  Cost-effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction . N Engl J Med . 1995;;332:1418-1424.
3 +
Kalish SC, Gurwitz JH, Krumholz HM, Avorn J.  Cost-effectiveness of model of thrombolytic therapy for acute myocardial infarction . J Gen Intern Med . 1995;;10:321-330.
4 +
Goel V, Naylor CD.  Potential cost-effectiveness of intravenous tissue plasminogen activator versus streptokinase for acute myocardial infarction . Can J Cardiol . 1992;;8:31-38.
5 +
Eisenberg JM.  Clinical economics: a guide to the economic analysis of clinical practices . JAMA . 1989;; 262:2879-2886.
6 +
Detsky AS, Naglie IG.  A clinician's guide to cost-effectiveness analysis . Ann Intern Med . 1990;; 113:147-154.
7 +
Elixhauser A, Luce BR, Taylor WR, Reblando J.  Health care CBA/CEA: an update on the growth and composition of the literature . Med Care . 1993;; 31( (suppl) ):JS1-JS11, JS18-JS149.
8 +
Backhouse ME, Backhouse RJ, Edey SA.  Economic evaluation bibliography . Health Econ . 1992;; 1( (suppl) ):1-236.
9 +
Russell LB, Gold MR, Seigel JE, Daniels N, Weinstein MC, for the Panel on Cost-Effectiveness in Health and Medicine.  The role of cost-effectiveness analysis in health and medicine . JAMA . 1996;; 276:1172-1177.
10 +
Richardson WS, Detsky AS, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VII: how to use a clinical decision analysis, A: are the results of the study valid? JAMA . 1995;;273:1292-1295.
11 +
Wilson MC, Hayward RSA, Tunis SR, Bass EB, Guyatt G, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VIII: how to use clinical practice guidelines, B: what are the recommendations and will they help you in caring for your patient? JAMA . 1995;;274:1630-1632.
12 +
Drummond MF, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes . Oxford, England: Oxford University Press; 1987;.
13 +
Luce BR, Elixhauser A. Standards for Socioeconomic Evaluation of Health Care Products and Services . Berlin, Germany: Springer Verlag; 1990;.
14 +
Kamlet MS. A Framework for Cost-Utility Analysis of Government Health Care Programs: Report to the Office of Disease Prevention and Health Promotion . Washington, DC: Public Health Service, US Dept of Health and Human Services in cooperation with the Foundation of Health Services Research; 1990;.
15 +
Topol EJ, Burek K, O'Neill WW, et al.  A randomized controlled trial of hospital discharge three days after myocardial infarction in the era of reperfusion . N Engl J Med . 1988;;318:1083-1088.
16 +
Weisbrod BA, Test MA, Stein LI.  Alternative to mental hospital treatment, II: economic benefit-cost analysis . Arch Gen Psychiatry . 1980;;37:400-405.
17 +
Mehrez A, Gafni A.  Quality-adjusted life years, utility theory, and healthy-years equivalents . Med Decis Making . 1989;;9:142-149.
18 +
Mugford M, Kingford J, Chalmers I.  Reducing the incidence of infection after caesarian section: implications of prophylaxis with antibiotics for hospital resources . BMJ . 1989;;299:1003-1006.
19 +
Hillman AL, Bloom BS.  Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs . Arch Intern Med . 1989;;149:2061-2065.
20 +
Graham DY, Agrawal NM, Roth SH.  Prevention of NSAID-induced gastric ulcer with the synthetic prostaglandin misoprostol: a multicentre, double-blind, placebo-controlled trial . Lancet . 1988;; 2:1277-1280.
21 +
Schulman KA, Lynn LA, Glick HA, Eisenberg JM.  Cost-effectiveness of low dose zidovudine therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection . Ann Intern Med . 1991;;114:798-802.
22 +
Concorde Coordinating Committee.  Concorde: MRC/ANRS randomised double-blind controlled trial of immediate and deferred zidovudine in symptom-free HIV infection . Lancet . 1994;;343:871-881.
23 +
Finkler SA.  The distinction between cost and charges . Ann Intern Med . 1982;;96:102-109.
24 +
Cohen DJ, Breall JA, Kalon KLH, et al.  Economics of elective coronary revascularization: comparison of costs and charges for conventional angioplasty, directional atherectomy, stenting and bypass surgery . J Am Coll Cardiol . 1993;;22:1052-1059.
25 +
Sifton DW. 1993 Red Book: Pharmacy's Fundamental Reference . Montvale, NJ: Medical Economics Data; 1993;.
26 +
Karlsson G, Johannesson M.  The decision rules of cost-effectiveness analysis . Pharmaco Econ . 1996;; 9:113-120.
27 +
Parsonage M, Neuberger H.  Discounting and health benefits . Health Econ . 1992;;1:71-76.
28 +
Cairns J.  Discounting and health benefits: another perspective . Health Econ . 1992;;1:76-79.
29 +
O'Brien BJ, Drummond MF, Labelle RJ, Willan A.  In search of power and significance: issues in the design and analysis of stochastic economic appraisals . Med Care . 1994;;32:150-163.
30 +
Udvarhelyi IS, Colditz GA, Rai A, Epstein MA.  Cost-effectiveness and cost-benefit analysis in the medical literature: are the methods being used correctly? Ann Intern Med . 1992;;116:238-244.
31 +
Epstein MA.  Cost-effectiveness of antihyperlipidemic therapy in the prevention of coronary heart disease: the case of cholestyramine . JAMA . 1987;;258:2381-2387.
32 +
Goldman L, Sia STB, Cook EF, Rutherford JD, Weinstein MC.  Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction . N Engl J Med . 1988;;319:152-157.

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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 +
The GUSTO Investigators.  An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction . N Engl J Med . 1993;;329:673-682.
2 +
Mark DB, Hlatky MA, Califf RM, et al.  Cost-effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction . N Engl J Med . 1995;;332:1418-1424.
3 +
Kalish SC, Gurwitz JH, Krumholz HM, Avorn J.  Cost-effectiveness of model of thrombolytic therapy for acute myocardial infarction . J Gen Intern Med . 1995;;10:321-330.
4 +
Goel V, Naylor CD.  Potential cost-effectiveness of intravenous tissue plasminogen activator versus streptokinase for acute myocardial infarction . Can J Cardiol . 1992;;8:31-38.
5 +
Eisenberg JM.  Clinical economics: a guide to the economic analysis of clinical practices . JAMA . 1989;; 262:2879-2886.
6 +
Detsky AS, Naglie IG.  A clinician's guide to cost-effectiveness analysis . Ann Intern Med . 1990;; 113:147-154.
7 +
Elixhauser A, Luce BR, Taylor WR, Reblando J.  Health care CBA/CEA: an update on the growth and composition of the literature . Med Care . 1993;; 31( (suppl) ):JS1-JS11, JS18-JS149.
8 +
Backhouse ME, Backhouse RJ, Edey SA.  Economic evaluation bibliography . Health Econ . 1992;; 1( (suppl) ):1-236.
9 +
Russell LB, Gold MR, Seigel JE, Daniels N, Weinstein MC, for the Panel on Cost-Effectiveness in Health and Medicine.  The role of cost-effectiveness analysis in health and medicine . JAMA . 1996;; 276:1172-1177.
10 +
Richardson WS, Detsky AS, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VII: how to use a clinical decision analysis, A: are the results of the study valid? JAMA . 1995;;273:1292-1295.
11 +
Wilson MC, Hayward RSA, Tunis SR, Bass EB, Guyatt G, for the Evidence-Based Medicine Working Group.  Users' guides to the medical literature, VIII: how to use clinical practice guidelines, B: what are the recommendations and will they help you in caring for your patient? JAMA . 1995;;274:1630-1632.
12 +
Drummond MF, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes . Oxford, England: Oxford University Press; 1987;.
13 +
Luce BR, Elixhauser A. Standards for Socioeconomic Evaluation of Health Care Products and Services . Berlin, Germany: Springer Verlag; 1990;.
14 +
Kamlet MS. A Framework for Cost-Utility Analysis of Government Health Care Programs: Report to the Office of Disease Prevention and Health Promotion . Washington, DC: Public Health Service, US Dept of Health and Human Services in cooperation with the Foundation of Health Services Research; 1990;.
15 +
Topol EJ, Burek K, O'Neill WW, et al.  A randomized controlled trial of hospital discharge three days after myocardial infarction in the era of reperfusion . N Engl J Med . 1988;;318:1083-1088.
16 +
Weisbrod BA, Test MA, Stein LI.  Alternative to mental hospital treatment, II: economic benefit-cost analysis . Arch Gen Psychiatry . 1980;;37:400-405.
17 +
Mehrez A, Gafni A.  Quality-adjusted life years, utility theory, and healthy-years equivalents . Med Decis Making . 1989;;9:142-149.
18 +
Mugford M, Kingford J, Chalmers I.  Reducing the incidence of infection after caesarian section: implications of prophylaxis with antibiotics for hospital resources . BMJ . 1989;;299:1003-1006.
19 +
Hillman AL, Bloom BS.  Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs . Arch Intern Med . 1989;;149:2061-2065.
20 +
Graham DY, Agrawal NM, Roth SH.  Prevention of NSAID-induced gastric ulcer with the synthetic prostaglandin misoprostol: a multicentre, double-blind, placebo-controlled trial . Lancet . 1988;; 2:1277-1280.
21 +
Schulman KA, Lynn LA, Glick HA, Eisenberg JM.  Cost-effectiveness of low dose zidovudine therapy for asymptomatic patients with human immunodeficiency virus (HIV) infection . Ann Intern Med . 1991;;114:798-802.
22 +
Concorde Coordinating Committee.  Concorde: MRC/ANRS randomised double-blind controlled trial of immediate and deferred zidovudine in symptom-free HIV infection . Lancet . 1994;;343:871-881.
23 +
Finkler SA.  The distinction between cost and charges . Ann Intern Med . 1982;;96:102-109.
24 +
Cohen DJ, Breall JA, Kalon KLH, et al.  Economics of elective coronary revascularization: comparison of costs and charges for conventional angioplasty, directional atherectomy, stenting and bypass surgery . J Am Coll Cardiol . 1993;;22:1052-1059.
25 +
Sifton DW. 1993 Red Book: Pharmacy's Fundamental Reference . Montvale, NJ: Medical Economics Data; 1993;.
26 +
Karlsson G, Johannesson M.  The decision rules of cost-effectiveness analysis . Pharmaco Econ . 1996;; 9:113-120.
27 +
Parsonage M, Neuberger H.  Discounting and health benefits . Health Econ . 1992;;1:71-76.
28 +
Cairns J.  Discounting and health benefits: another perspective . Health Econ . 1992;;1:76-79.
29 +
O'Brien BJ, Drummond MF, Labelle RJ, Willan A.  In search of power and significance: issues in the design and analysis of stochastic economic appraisals . Med Care . 1994;;32:150-163.
30 +
Udvarhelyi IS, Colditz GA, Rai A, Epstein MA.  Cost-effectiveness and cost-benefit analysis in the medical literature: are the methods being used correctly? Ann Intern Med . 1992;;116:238-244.
31 +
Epstein MA.  Cost-effectiveness of antihyperlipidemic therapy in the prevention of coronary heart disease: the case of cholestyramine . JAMA . 1987;;258:2381-2387.
32 +
Goldman L, Sia STB, Cook EF, Rutherford JD, Weinstein MC.  Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction . N Engl J Med . 1988;;319:152-157.

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