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A 4-year, cluster-randomized, controlled childhood obesity prevention study: STOPP.

https://arctichealth.org/en/permalink/ahliterature99038
Source
Int J Obes (Lond). 2009 Apr;33(4):408-17
Publication Type
Article
Date
Apr-2009
Author
C. Marcus
G. Nyberg
A. Nordenfelt
M. Karpmyr
J. Kowalski
U. Ekelund
Author Affiliation
Division of Pediatrics, Karolinska Institutet, Department of Clinical Science, Intervention and Technology, National Childhood Obesity Centre, Stockholm, Sweden. claude.marcus@ki.se
Source
Int J Obes (Lond). 2009 Apr;33(4):408-17
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Anthropometry
Child
Cluster analysis
Female
Health Promotion - organization & administration
Humans
Longitudinal Studies
Male
Obesity - epidemiology - prevention & control
Overweight - epidemiology - prevention & control
Parents - psychology
Physical Fitness - psychology
Prevalence
Risk Reduction Behavior
School Health Services
Sweden - epidemiology
Abstract
OBJECTIVE: To assess the efficacy of a school-based intervention programme to reduce the prevalence of overweight in 6 to 10-year-old children. DESIGN: Cluster-randomized, controlled study. SUBJECTS: A total of 3135 boys and girls in grades 1-4 were included in the study. METHODS: Ten schools were selected in Stockholm county area and randomized to intervention (n=5) and control (n=5) schools. Low-fat dairy products and whole-grain bread were promoted and all sweets and sweetened drinks were eliminated in intervention schools. Physical activity (PA) was aimed to increase by 30 min day(-1) during school time and sedentary behaviour restricted during after school care time. PA was measured by accelerometry. Eating habits at home were assessed by parental report. Eating disorders were evaluated by self-report. RESULTS: The prevalence of overweight and obesity decreased by 3.2% (from 20.3 to 17.1) in intervention schools compared with an increase of 2.8% (from 16.1 to 18.9) in control schools (P
PubMed ID
19290010 View in PubMed
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12-month follow-up of an exploratory 'brief intervention' for high-frequency cannabis users among Canadian university students.

https://arctichealth.org/en/permalink/ahliterature124885
Source
Subst Abuse Treat Prev Policy. 2012;7:15
Publication Type
Article
Date
2012
Author
Benedikt Fischer
Wayne Jones
Paul Shuper
Jürgen Rehm
Author Affiliation
Centre for Applied Research in Mental Health and Addictions, Faculty of Health Sciences, Simon Fraser University, 2400, 515 West Hastings St,, Vancouver, BC, V6B 5K3, Canada. bfischer@sfu.ca
Source
Subst Abuse Treat Prev Policy. 2012;7:15
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Female
Follow-Up Studies
Health Promotion - methods
Humans
Male
Marijuana Smoking - epidemiology - prevention & control
Ontario - epidemiology
Outcome Assessment (Health Care)
Questionnaires
Risk Reduction Behavior
Young Adult
Abstract
One in three young people use cannabis in Canada. Cannabis use can be associated with a variety of health problems which occur primarily among intensive/frequent users. Availability and effectiveness of conventional treatment for cannabis use is limited. While Brief Interventions (BIs) have been shown to result in short-term reductions of cannabis use risks or problems, few studies have assessed their longer-term effects. The present study examined 12-month follow-up outcomes for BIs in a cohort of young Canadian high-frequency cannabis users where select short-term effects (3 months) had previously been assessed and demonstrated.
N=134 frequent cannabis users were recruited from among university students in Toronto, randomized to either an oral or a written cannabis BI, or corresponding health controls, and assessed in-person at baseline, 3-months, and 12-months. N=72 (54%) of the original sample were retained for follow-up analyses at 12-months where reductions in 'deep inhalation/breathholding' (Q=13.1; p
Notes
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PubMed ID
22538183 View in PubMed
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A 32-year longitudinal study of alcohol consumption in Swedish women: Reduced risk of myocardial infarction but increased risk of cancer.

https://arctichealth.org/en/permalink/ahliterature275258
Source
Scand J Prim Health Care. 2015;33(3):153-62
Publication Type
Article
Date
2015
Author
Dominique Hange
Jóhann A Sigurdsson
Cecilia Björkelund
Valter Sundh
Calle Bengtsson
Source
Scand J Prim Health Care. 2015;33(3):153-62
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects
Beer
Diabetes Mellitus - epidemiology
Ethanol - adverse effects - therapeutic use
Female
Humans
Incidence
Longitudinal Studies
Middle Aged
Myocardial Infarction - prevention & control
Neoplasms - etiology
Proportional Hazards Models
Prospective Studies
Risk factors
Risk Reduction Behavior
Stroke - epidemiology
Sweden - epidemiology
Abstract
To assess associations between the intake of different types of alcoholic beverages and the 32-year incidence of myocardial infarction, stroke, diabetes, and cancer, as well as mortality, in a middle-aged female population.
Prospective study.
Gothenburg, Sweden, population about 430 000.
Representative sample of a general population of women (1462 in total) aged 38 to 60 years in 1968-1969, followed up to the ages of 70 to 92 years in 2000-2001.
Associations between alcohol intake and later risk of mortality and morbidity from myocardial infarction, stroke, diabetes, and cancer, studied longitudinally.
During the follow-up period, 185 women developed myocardial infarction, 162 developed stroke, 160 women became diabetic, and 345 developed cancer. Women who drank beer had a 30% lower risk (hazards ratio (HR) 0.70, 95% confidence interval (CI) 0.50-0.95) of developing myocardial infarcion and almost half the risk (HR 0.51 CI 0.33-0.80). A significant association between increased risk of death from cancer and high spirits consumption was also shown (hazards ratio [HR] 1.47, CI 1.06-2.05).
Women with moderate consumption of beer had a reduced risk of developing myocardial infarction. High spirits consumption was associated with increased risk of cancer mortality.
Notes
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PubMed ID
26194171 View in PubMed
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The 2005 British Columbia Smoking Cessation Mass Media Campaign and short-term changes in smoking.

https://arctichealth.org/en/permalink/ahliterature164149
Source
J Public Health Manag Pract. 2007 May-Jun;13(3):296-306
Publication Type
Article
Author
Lynda Gagné
Author Affiliation
School of Public Administration at University of Victoria, British Columbia, Canada. lgagne@uvic.ca
Source
J Public Health Manag Pract. 2007 May-Jun;13(3):296-306
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
British Columbia - epidemiology
Canada - epidemiology
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice
Health Promotion - methods
Humans
Interviews as Topic
Mass Media
Middle Aged
Prevalence
Program Evaluation
Public Health Administration - methods
Risk Reduction Behavior
Smoking - adverse effects - epidemiology - prevention & control
Smoking Cessation - psychology - statistics & numerical data
Social Marketing
Tobacco Smoke Pollution - adverse effects - prevention & control - statistics & numerical data
Workplace - standards - statistics & numerical data
Abstract
The objective of this study was to evaluate the impact of the 2005 British Columbia Ministry of Health Smoking Cessation Mass Media Campaign on short-term smoking behavior.
National cross-sectional data are used with a quasi-experimental approach to test the impact of the campaign.
Findings indicate that prevalence and average number of cigarettes smoked per day deviated upward from trend for the rest of Canada (P = .08; P = .01) but not for British Columbia. They also indicate that British Columbia smokers in lower risk groups reduced their average daily consumption of cigarettes over and above the 1999-2004 trend (-2.23; P = .10), whereas smokers in the rest of Canada did not, and that British Columbia smokers in high-risk groups did not increase their average daily consumption of cigarettes over and above the 1999-2004 trend, whereas smokers in the rest of Canada did (2.97; P = .01).
The overall poorer performance of high-risk groups is attributed to high exposure to cigarette smoking, which reduces a smoker's chances of successful cessation. In particular, high-risk groups are by definition more likely to be exposed to smoking by peers, but are also less likely to work in workplaces with smoking bans, which are shown to have a substantial impact on prevalence. Results suggest that for mass media campaigns to be more effective with high-risk groups, they need to be combined with other incentives, and that more prolonged interventions should be considered.
PubMed ID
17435497 View in PubMed
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The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy.

https://arctichealth.org/en/permalink/ahliterature163300
Source
Can J Cardiol. 2007 May 15;23(7):539-50
Publication Type
Conference/Meeting Material
Article
Date
May-15-2007
Author
Nadia A Khan
Brenda Hemmelgarn
Raj Padwal
Pierre Larochelle
Jeff L Mahon
Richard Z Lewanczuk
Finlay A McAlister
Simon W Rabkin
Michael D Hill
Ross D Feldman
Ernesto L Schiffrin
Norman R C Campbell
Alexander G Logan
Malcolm Arnold
Gordon Moe
Tavis S Campbell
Alain Milot
James A Stone
Charlotte Jones
Lawrence A Leiter
Richard I Ogilvie
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Kevin D Burns
Marcel Ruzicka
Jacques deChamplain
George Pylypchuk
Norm Gledhill
Robert Petrella
Jean-Martin Boulanger
Luc Trudeau
Robert A Hegele
Vincent Woo
Phil McFarlane
Rhian M Touyz
Sheldon W Tobe
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia. nakhan@shaw.ca
Source
Can J Cardiol. 2007 May 15;23(7):539-50
Date
May-15-2007
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Diet, Sodium-Restricted
Health promotion
Humans
Hypertension - drug therapy - prevention & control - therapy
Patient Education as Topic
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
To provide updated, evidence-based recommendations for the prevention and management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence was reviewed from randomized controlled trials and systematic reviews of trials. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. However, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity and mortality data in this field. For treatment of patients with kidney disease, the progression of kidney dysfunction was also accepted as a clinically relevant primary outcome.
A Cochrane collaboration librarian conducted an independent MEDLINE search from 2005 to August 2006 to update the 2006 Canadian Hypertension Education Program recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by both content and methodological experts using prespecified levels of evidence.
Dietary lifestyle modifications for prevention of hypertension, in addition to a well-balanced diet, include a dietary sodium intake of less than 100 mmol/day. In hypertensive patients, the dietary sodium intake should be limited to 65 mmol/day to 100 mmol/day. Other lifestyle modifications for both normotensive and hypertensive patients include: performing 30 min to 60 min of aerobic exercise four to seven days per week; maintaining a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm in men and less than 88 cm in women); limiting alcohol consumption to no more than 14 units per week in men or nine units per week in women; following a diet reduced in saturated fat and cholesterol, and one that emphasizes fruits, vegetables and low-fat dairy products, dietary and soluble fibre, whole grains and protein from plant sources; and considering stress management in selected individuals with hypertension. For the pharmacological management of hypertension, treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and any comorbid conditions: blood pressure should be lowered to lower than 140/90 mmHg in all patients and lower than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease. Most patients require more than one agent to achieve these blood pressure targets. In adults without compelling indications for other agents, initial therapy should include thiazide diuretics; other agents appropriate for first-line therapy for diastolic and/or systolic hypertension include angiotensin-converting enzyme (ACE) inhibitors (except in black patients), long-acting calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs) or beta-blockers (in those younger than 60 years of age). First-line therapy for isolated systolic hypertension includes long-acting dihydropyridine CCBs or ARBs. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction, or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with cerebrovascular disease, an ACE inhibitor plus diuretic combination is preferred; in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended; and in patients with diabetes mellitus, ACE inhibitors or ARBs (or, in patients without albuminuria, thiazides or dihydropyridine CCBs) are appropriate first-line therapies. All hypertensive patients with dyslipidemia should be treated using the thresholds, targets and agents outlined in the Canadian Cardiovascular Society position statement (recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease). Selected high-risk patients with hypertension who do not achieve thresholds for statin therapy according to the position paper should nonetheless receive statin therapy. Once blood pressure is controlled, acetylsalicylic acid therapy should be considered.
All recommendations were graded according to strength of the evidence and voted on by the 57 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
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Comment In: Can J Cardiol. 2007 May 15;23(7):603-417593584
PubMed ID
17534460 View in PubMed
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2010 Canadian Hypertension Education Program (CHEP) recommendations: the scientific summary - an update of the 2010 theme and the science behind new CHEP recommendations.

https://arctichealth.org/en/permalink/ahliterature143446
Source
Can J Cardiol. 2010 May;26(5):236-40
Publication Type
Article
Date
May-2010
Author
Norman R C Campbell
Janusz Kaczorowski
Richard Z Lewanczuk
Ross Feldman
Luc Poirier
Margaret Moy Kwong
Marcel Lebel
Finlay A McAlister
Sheldon W Tobe
Author Affiliation
Department of Medicine, University of Calgary, Alberta. ncampbel@ucalgary.ca
Source
Can J Cardiol. 2010 May;26(5):236-40
Date
May-2010
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - administration & dosage
Canada
Diet, Sodium-Restricted
Female
Health promotion
Humans
Hypertension - prevention & control - therapy
Life Style
Male
Patient Education as Topic
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Risk Reduction Behavior
Abstract
The present article is a summary of the theme, the key recommendations for management of hypertension and the supporting clinical evidence of the 2010 Canadian Hypertension Education Program (CHEP). In 2010, CHEP emphasizes the need for health care professionals to stay informed about hypertension through automated updates at www.htnupdate.ca. A new interactive Internet-based lecture series will be available in 2010 and a program to train community hypertension leaders will be expanded. Patients can also sign up to receive regular updates in a pilot program at www.myBPsite.ca. In 2010, the new recommendations include consideration for using automated office blood pressure monitors, new targets for dietary sodium for the prevention and treatment of hypertension that are aligned with the national adequate intake values, and recommendations for considering treatment of selected hypertensive patients at high risk with calcium channel blocker/angiotensin-converting enzyme inhibitor combinations and the use of angiotensin receptor blockers.
Notes
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PubMed ID
20485687 View in PubMed
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Absolute risk reductions and numbers needed to treat can be obtained from adjusted survival models for time-to-event outcomes.

https://arctichealth.org/en/permalink/ahliterature149699
Source
J Clin Epidemiol. 2010 Jan;63(1):46-55
Publication Type
Article
Date
Jan-2010
Author
Peter C Austin
Author Affiliation
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada. peter.austin@ices.on.ca
Source
J Clin Epidemiol. 2010 Jan;63(1):46-55
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Female
Heart Failure - drug therapy - mortality
Humans
Male
Ontario - epidemiology
Proportional Hazards Models
Research Design
Risk Reduction Behavior
Survival Analysis
Treatment Outcome
Abstract
Cox proportional hazards regression models are frequently used to determine the association between exposure and time-to-event outcomes in both randomized controlled trials and in observational cohort studies. The resultant hazard ratio is a relative measure of effect that provides limited clinical information.
A method is described for deriving absolute reductions in the risk of an event occurring within a given duration of follow-up time from a Cox regression model. The associated number needed to treat can be derived from this quantity. The method involves determining the probability of the outcome occurring within the specified duration of follow-up if each subject in the cohort was treated and if each subject was untreated, based on the covariates in the regression model. These probabilities are then averaged across the study population to determine the average probability of the occurrence of an event within a specific duration of follow-up in the population if all subjects were treated and if all subjects were untreated.
Risk differences and numbers needed to treat.
Absolute measures of treatment effect can be derived in prospective studies when Cox regression is used to adjust for possible imbalance in prognostically important baseline covariates.
PubMed ID
19595575 View in PubMed
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Absolute risk reductions for local recurrence after postoperative radiotherapy after sector resection for ductal carcinoma in situ of the breast.

https://arctichealth.org/en/permalink/ahliterature87239
Source
J Clin Oncol. 2008 Mar 10;26(8):1247-52
Publication Type
Article
Date
Mar-10-2008
Author
Holmberg Lars
Garmo Hans
Granstrand Bengt
Ringberg Anita
Arnesson Lars-Gunnar
Sandelin Kerstin
Karlsson Per
Anderson Harald
Emdin Stefan
Author Affiliation
Division of Cancer Studies, Thomas Guy House, 3rd Floor, King's College London, Guy's Campus, London SE1 9RT, United Kingdom. lars.holmberg@kcl.ac.uk
Source
J Clin Oncol. 2008 Mar 10;26(8):1247-52
Date
Mar-10-2008
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - radiotherapy - surgery
Carcinoma, Ductal, Breast - radiotherapy - surgery
Carcinoma, Intraductal, Noninfiltrating - radiotherapy - surgery
Female
Humans
Middle Aged
Neoplasm Recurrence, Local - etiology - prevention & control
Postoperative Period
Risk Reduction Behavior
Survival Rate
Sweden
Treatment Outcome
Abstract
PURPOSE: Evaluate the effects of radiotherapy after sector resection for ductal carcinoma in situ of the breast (DCIS) in patient groups as defined by age, size of the lesion, focality, completeness of excision and mode of detection. PATIENTS AND METHODS: A total of 1,067 women in Sweden were randomly assigned to either postoperative radiotherapy (RT) or control from 1987 to 1999, and 1,046 were followed for a mean of 8 years. The main outcome was new ipsilateral breast cancer events and distant metastasis-free survival analyzed according to intention to treat. RESULTS: There were 64 ipsilateral events in the RT arm and 141 in the control group corresponding to a risk reduction of 16.0 percentage points at 10 years (95% CI, 10.3% to 21.6%) and a relative risk of 0.40 (95% CI, 0.30 to 0.54). There was no statistically significant difference in distant metastasis-free survival. There was an effect modification by age, yielding a low effect of RT in women younger than 50, but substantial protection in women older than 60 years. The age effect was not confounded by focality, lesion size, completeness of excision, or detection mode. There was no group as defined by our stratification variables that had a low risk without radiotherapy. CONCLUSION: Our results indicate that younger women have a low protective effect of conventional RT after sector resection. Older women benefit substantially. We caution that the age effect was seen in a subgroup analysis. Further search with conventional clinical variables for a low risk group that does not need RT does not seem fruitful.
PubMed ID
18250350 View in PubMed
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Absolute risk reductions, relative risks, relative risk reductions, and numbers needed to treat can be obtained from a logistic regression model.

https://arctichealth.org/en/permalink/ahliterature152508
Source
J Clin Epidemiol. 2010 Jan;63(1):2-6
Publication Type
Article
Date
Jan-2010
Author
Peter C Austin
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ontario M4N 3M5, Canada. peter.austin@ices.on.ca
Source
J Clin Epidemiol. 2010 Jan;63(1):2-6
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Data Interpretation, Statistical
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Logistic Models
Myocardial Infarction - drug therapy - mortality
Ontario - epidemiology
Risk Reduction Behavior
Treatment Outcome
Abstract
Logistic regression models are frequently used in cohort studies to determine the association between treatment and dichotomous outcomes in the presence of confounding variables. In a logistic regression model, the association between exposure and outcome is measured using the odds ratio (OR). The OR can be difficult to interpret and only approximates the relative risk (RR) in certain restrictive settings. Several authors have suggested that for dichotomous outcomes, RRs, RR reductions, absolute risk reductions, and the number needed to treat (NNT) are more clinically meaningful measures of treatment effect.
We describe a method for deriving clinically meaningful measures of treatment effect from a logistic regression model. This method involves determining the probability of the outcome if each subject in the cohort was treated and if each subject was untreated. These probabilities are then averaged across the study cohort to determine the average probability of the outcome in the population if all subjects were treated and if they were untreated.
Risk differences, RRs, and NNTs were derived using a logistic regression model.
Clinically meaningful measures of effect can be derived from a logistic regression model in a cohort study. These methods can also be used in randomized controlled trials when logistic regression is used to adjust for possible imbalance in prognostically important baseline covariates.
Notes
Comment In: J Clin Epidemiol. 2010 Jan;63(1):7-819762212
PubMed ID
19230611 View in PubMed
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Acarbose for the prevention of Type 2 diabetes, hypertension and cardiovascular disease in subjects with impaired glucose tolerance: facts and interpretations concerning the critical analysis of the STOP-NIDDM Trial data.

https://arctichealth.org/en/permalink/ahliterature179962
Source
Diabetologia. 2004 Jun;47(6):969-75; discussion 976-7
Publication Type
Article
Date
Jun-2004
Author
J-L Chiasson
R G Josse
R. Gomis
M. Hanefeld
A. Karasik
M. Laakso
Author Affiliation
Research Centre, Centre hospitalier de l'Université de Montréal-Hôtel-Dieu, Department of Medicine, University of Montreal, 3850 St. Urbain Street, Rm 8-202, Montreal, Quebec H2W 1T7, Canada. jean.louis.chiasson@umontreal.ca
Source
Diabetologia. 2004 Jun;47(6):969-75; discussion 976-7
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Acarbose - therapeutic use
Blood Glucose - chemistry
Body Weight - drug effects
Canada
Cardiovascular Diseases - complications - drug therapy - prevention & control
Clinical Protocols
Data Collection - ethics - methods
Diabetes Mellitus, Type 2 - complications - drug therapy - prevention & control
Double-Blind Method
Eating - physiology
Ethics, Clinical
Fasting - blood
Female
Follow-Up Studies
Glucose Intolerance - complications - drug therapy - prevention & control
Humans
Hypertension - complications - drug therapy - prevention & control
Male
Middle Aged
Patient Selection
Randomized Controlled Trials as Topic
Reproducibility of Results
Research Design
Risk Reduction Behavior
Stroke - classification - etiology - prevention & control
Time Factors
Treatment Outcome
Withholding Treatment - ethics
Abstract
The STOP-NIDDM Trial has shown that acarbose treatment in subjects with impaired glucose tolerance is associated with a significant risk reduction in the development of diabetes, hypertension and cardiovascular complications. Kaiser and Sawicki have accused the investigators of the STOP-NIDDM Trial of major biases in the conduct of the study, of manipulating the data and of conflict of interest. The aim of this paper is to present data and explanations refuting these allegations. In the STOP-NIDDM Trial, 61 subjects were excluded from the efficacy analysis before unblinding for legitimate reasons: failure to satisfy major entry criteria (n=17) and lack of post-randomisation data (n=44). Blinding and randomisation were carried out by an independent biostatistician. Titration of placebo/acarbose is well described in the protocol and in the study design paper. Of the study population, 9.3% had a fasting plasma glucose of > or =7.0 mmol/l at screening and could have been diabetic according to the new diagnostic criteria. However, even if these subjects are excluded, patients having acarbose treatment still saw a significant risk reduction in the development of diabetes (p=0.0027). The changes in weight are consistent in different publications and are related to different times of follow-up and assessment. Weight change does have an effect on the development of diabetes, but acarbose treatment is still effective even after adjusting for this (p=0.0063). The cardiovascular endpoints were a clearly designated assessment in the original protocol, and only those defined in the protocol and ascertained by the independent Cardiovascular Event Adjudication Committee were used in the analysis. Hypertension was defined according to the most recent diagnostic criteria. The STOP-NIDDM Trial results are scientifically sound and credible. The investigators stand strongly behind these results demonstrating that acarbose treatment is associated with a delay in the development of diabetes, hypertension and cardiovascular complications in a high-risk population with IGT.
Notes
Comment In: Diabetologia. 2004 Jun;47(6):976-715150689
Comment On: Diabetologia. 2004 Mar;47(3):575-8014727025
PubMed ID
15164169 View in PubMed
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