Recommended Pages at evidenceinmedicine.org
Evidence In Medicine - Pharma behaving well?
evidenceinmedicine.org — “We have known for many years now that patients having an acute coronary syndrome (ACS) do better if they are immediately treated with aspirin, and that they do even better if in addition to that single antiplatelet agent they are also treated with clopidogrel. In 2009, the PLATO trial was published in the NEJM. It was a randomized trial in more than 18,000 people having an ACS, comparing the benefits of adding either clopidogrel or the newer agent ticagrelor to aspirin. Ticagrelor appeared to ca” View full resource at evidenceinmedicine.org
Most Recently Shared on February 7, 2012 at 3:28 am By:
David Rind Physician, Doctor, and Internist
Pharma behaving well? http://t.co/EJKtBo6B
Evidence In Medicine - Startling Results
evidenceinmedicine.org — “I've written previously about how the plausibility of results might affect the interpretation of new evidence from a trial. In particular, I argued that results that cannot fit in with a web of prior evidence must be viewed with skepticism. While being overly credulous of results that are unlikely to be true is a common problem in medicine, a less common but more severe problem is how unwilling doctors tend to be to believe a new result that upsets past dogma even when that dogma was built on lo” View full resource at evidenceinmedicine.org
Most Recently Shared on November 13, 2011 at 4:14 am By:
David Rind Physician, Doctor, and Internist
Startling Results http://t.co/7Kfykm50
Evidence In Medicine - Not so SHARP
evidenceinmedicine.org — “I've written a bit previously in this blog about the evidence around lipid-lowering therapies, and in particular about the lack of evidence for combining other lipid-lowering therapies, including ezetimibe, with statins. Tomorrow, the FDA will apparently be taking up a request to approve Vytorin (simvastatin/ezetimibe) for the treatment of patients with chronic kidney disease (CKD). As a result of this request for approval, we also have access to the FDA review of data from the SHARP trial. SHAR” View full resource at evidenceinmedicine.org
Most Recently Shared on November 2, 2011 at 12:45 am By:
David Rind Physician, Doctor, and Internist
Not so SHARP http://t.co/qLxc6uoD
Evidence In Medicine - Activated Protein C and Conflicting Trials
evidenceinmedicine.org — “I won a bottle of wine this week. At least in theory. I haven't posted to this blog in a long while, but the opportunity to brag about this has overcome inertia. A few years ago I was at a cookout with some friends and colleagues, and got into a discussion with one of them, an emergency physician and sepsis expert, about activated protein C. Many modifiers of the immune response to sepsis have been studied in an attempt to lower the large mortality rate of severe sepsis, but almost none have sho” View full resource at evidenceinmedicine.org
Most Recently Shared on October 30, 2011 at 3:01 am By:
David Rind Physician, Doctor, and Internist
Activated Protein C and Conflicting Trials http://t.co/FLWxaqAM
Evidence In Medicine - Independent Events
evidenceinmedicine.org — “I was speaking with a patient recently who was explaining why he thought that colon cancer screening with fecal occult blood testing (FOBT) was equivalent to colonoscopy. He wished to avoid colonoscopy for all the usual reasons, but also believed logically that it was not a superior test. I won't get into the actual evidence behind the two methods of screening; that is not an issue for this post. Instead, I want to discuss his argument. He assumed that colonoscopy had a sensitivity (probability ” View full resource at evidenceinmedicine.org
Most Recently Shared on September 19, 2010 at 2:32 am By:
David Rind Physician, Doctor, and Internist
Independent Events http://bit.ly/cLrKYX
Evidence In Medicine - Statins, Diabetes, and Attacking a Meta-Analysis
evidenceinmedicine.org — “I'm a little late reading the June 19th Lancet, but was intrigued to find letters in response to the meta-analysis by Sattar et al. looking at whether statin therapy increases the risk of diabetes. I had previously written about this well-performed meta-analysis, and also written about some unfair ways that people use to try to attack randomized trials, and these letters provide an interesting (at least to me) intersection between these posts. Letters in academic scientific journals are sociolog” View full resource at evidenceinmedicine.org
Most Recently Shared on June 29, 2010 at 2:23 am By:
David Rind Physician, Doctor, and Internist
Statins, Diabetes, and Attacking a Meta-Analysis http://bit.ly/9PPUQv
Evidence In Medicine - CANOE and Diabetes as a Surrogate Endpoint
evidenceinmedicine.org — “In my most recent post, I commented on the DREAM trial's problems with composite endpoints, but also touched on the issue of using diabetes as an endpoint that was assessed while patients were on rosiglitazone. Today the Lancet (which published DREAM) published online CANOE, a trial of relatively low dose rosiglitazone and metformin for the "prevention" of diabetes. Given the timing right after my discussion of DREAM I feel like I should comment on CANOE as well. Although I want to mai” View full resource at evidenceinmedicine.org
Most Recently Shared on June 3, 2010 at 1:55 am By:
David Rind Physician, Doctor, and Internist
In my most recent post, I commented on the DREAM trial's problems with composite endpoints, but also touched on the ... http://bit.ly/czrYMX
Evidence In Medicine - Composite Endpoints and the CREST Trial
evidenceinmedicine.org — “In recent years, a common practice in clinical trials is to make the primary endpoint a composite endpoint. That is, the primary endpoint is a combination of various clinical events that might happen, such as heart attack or death or stroke, where any one of those events would count as part of the composite endpoint. There can be good reasons for composite endpoints. If a single therapy is likely to have similar effects on a number of different related endpoints (such as cardiovascular events) c” View full resource at evidenceinmedicine.org
Most Recently Shared on May 31, 2010 at 3:36 am By:
David Rind Physician, Doctor, and Internist
Composite Endpoints and the CREST Trial http://bit.ly/adECfY
Evidence In Medicine - Revere's Thought Experiment and Observational Studies
evidenceinmedicine.org — “Over at Effect Measure, Revere has posed a thought experiment (or, perhaps, a disguised real experiment) that provides a valuable jumping off point for discussing the worth of observational data. In brief, Revere describes an uncontrolled study for a new application of an antiepileptic drug as a treatment for refractory hypertension. A study is conducted by administering the drug to 29 patients and checking their blood pressures at baseline and after a month of therapy. I glanced at the comments” View full resource at evidenceinmedicine.org
Most Recently Shared on January 4, 2010 at 3:09 am By:
David Rind Physician, Doctor, and Internist
Revere's Thought Experiment and Observational Studies http://bit.ly/5LAJnj
Evidence In Medicine - HIV Vaccines, p values, and Proof
evidenceinmedicine.org — “As mentioned in my last post, I want to continue the discussion of plausibility with the recent evidence suggesting benefit from an AIDS vaccine. This was a randomized, placebo-controlled trial in 16,000 adults, that, at least in the initial press releases, showed a statistically significant 31% decrease in HIV infection in vaccinated individuals. How confident should we be in the results? The analysis that showed the statistically significant benefit (p = 0.04), was a reasonable one. There were” View full resource at evidenceinmedicine.org
Most Recently Shared on December 2, 2009 at 2:43 am By:
David Rind Physician, Doctor, and Internist
HIV Vaccines, p values, and Proof http://bit.ly/6JAfwf
Evidence In Medicine - Proof, Plausibility, and a Tale of Two Viruses
evidenceinmedicine.org — “Listening to NPR There was a third incitement to this blog that I have not yet mentioned, as I am not currently in possession of an asbestos suit, but I feel the time has come to discuss it. I was driving to work listening to NPR's Morning Edition last month when I heard, "We have news, now, of a scientific breakthrough about a disease that affects over a million people in the U.S." My ears perked up, wondering what major breakthrough I had missed. I learned from the interview that an ” View full resource at evidenceinmedicine.org
Most Recently Shared on November 30, 2009 at 3:48 am By:
David Rind Physician, Doctor, and Internist
Proof, Plausibility, and a Tale of Two Viruses http://www.evidenceinmedicine.org/2009/11/plausibility-and-a-tale-of-two-viruses.html
Evidence In Medicine - Vitamins and Faith
evidenceinmedicine.org — “I'd mentioned in an earlier post that a relative was prescribed fairly high dose vitamin D by her primary care physician despite a blood test showing that her vitamin D level was in the normal range. Her PCP may not be much of an outlier. Among the residents I work with, I've been encountering a lot of desire to prescribe vitamin D to pretty much everyone. Why the willingness to administer vitamins? Would these same doctors feel that a drug with similar levels of evidence for safety and efficacy” View full resource at evidenceinmedicine.org
Most Recently Shared on November 24, 2009 at 3:03 am By:
David Rind Physician, Doctor, and Internist
Vitamins and Faith http://bit.ly/7OqBS3
Evidence In Medicine - Pharma, Evidence, and Trust
evidenceinmedicine.org — “A number of the other blogs that have noted the existence of this blog seem to have "pharma" in their titles in one way or another, and the implication is not that the blogger likes much about big pharma. in the late 1990s, when i was spending much of my clinical time providing hiv care, i was a defender of pharma on usenet, at least as it related to hiv. we'd discovered the hiv virus in 1985, and by late 1995 we had a spectacularly successful treatment, due, at least in part, to the e” View full resource at evidenceinmedicine.org
Most Recently Shared on November 21, 2009 at 9:49 pm By:
David Rind Physician, Doctor, and Internist
Pharma, Evidence, and Trust http://bit.ly/69KLGm
Evidence In Medicine - ARBITER 6 and Combining Therapies with Statins
evidenceinmedicine.org — “The results from ARBITER 6 were released this week. The interpretation is less clear. I've been in a minority who has doubted that most drugs that lower LDL are actually beneficial in primary prevention. Statins clearly show benefit, but really no other agents have shown a reduction in all cause mortality or, in primary prevention, in cardiovascular mortality. As such, I'd been raising concerns about ezetimibe even before ENHANCE was published, and have been unconvinced that anyone should be tre” View full resource at evidenceinmedicine.org
Most Recently Shared on November 18, 2009 at 2:42 pm By:
David Rind Physician, Doctor, and Internist
ARBITER 6 and Combining Therapies with Statins http://bit.ly/3MExfv
Evidence In Medicine - Opinion, Evidence, and Consensus Statements
evidenceinmedicine.org — “In the future, i'll write more about this subject, since the distinction between expert opinion and clinical experience seems to cause unending confusion to people who write and talk about ebm. for now, though, i want to write about the second recent event that caused me to decide to blog on evidence and medicine. i caught a snippet on npr's science friday where they were talking about concussions in athletes and heard the following: "and take a very careful step-wise return not just to the” View full resource at evidenceinmedicine.org
Most Recently Shared on November 17, 2009 at 8:34 pm By:
David Rind Physician, Doctor, and Internist
Opinion, Evidence, and Consensus Statements http://www.evidenceinmedicine.org/2009/11/opinion-evidence-and-consensus-statements.html
