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ARS (opens in new window) - Proxy me
Journal Club - 2007-05-22
1. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy.
Kahn SE, Haffner SM, Heise MA, Herman WH, Holman RR, Jones NP, Kravitz BG, Lachin JM, O'Neill MC, Zinman B, Viberti G, ADOPT Study Group.
N Engl J Med 2006;355(23):2427-43. PMID: 17145742
PubMed: Abstract - Related articles
Fulltext options: N Engl J Med - CrossRef - DOI - EBSCO - OVID
Summary: "The potential risks and benefits, the profile of adverse events, and the costs of these three drugs should all be considered to help inform the choice of pharmacotherapy for patients with type 2 diabetes.
Editorial at N Engl J Med. 2006 Dec 7;355(23):2477-80 |
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1. Which drug looks best?
But
Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes. NEJM 2007
and earlier this year:
Rosiglitazone may cause fractures. (FDA alert)
Consider using http://firstwatch.jwatch.org/ (free & fast) or JournalWatch (subscription)
2. Approximately, how many patients do you have to treat before one patient to have and MI (if the results are proved correct)? Hint: use any one of the sutdyies in Table 5 as an example.
1. Contradicted and initially stronger effects in highly cited clinical research.
Ioannidis JP.
JAMA 2005;294(2):218-28. PMID: 16014596
PubMed: Abstract - Related articles
Fulltext options: JAMA - CrossRef - DOI - EBSCO - OVID
| Summary: "Contradiction and initially stronger effects are not unusual in highly cited research of clinical interventions and their outcomes. The extent to which high citations may provoke contradictions and vice versa needs more study. Controversies are most common with highly cited nonrandomized studies, but even the most highly cited randomized trials may be challenged and refuted over time, especially small ones." |
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3. Why does this happen?
2. Timing of new black box warnings and withdrawals for prescription medications.
Lasser KE, Allen PD, Woolhandler SJ, Himmelstein DU, Wolfe SM, Bor DH.
JAMA 2002;287(17):2215-20. PMID: 11980521
PubMed: Abstract - Related articles
Fulltext options: JAMA - EBSCO - OVID
Summary: "Serious ADRs commonly emerge after Food and Drug Administration approval. The safety of new agents cannot be known with certainty until a drug has been on the market for many years."
Editorial at JAMA. 2002 May 1;287(17):2273-5 |
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4. Why does this happen?
Message: Never be the first nor last doc on the block to prescribe a new drug (PMID 8103150 ).
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