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Titolo:
Observation and experiment with the efficacy of drugs: A warning example from a cohort of nonsteroidal anti-inflammatory and ulcer-healing drug users
Autore:
McMahon, AD;
Indirizzi:
Univ Glasgow, Robertson Ctr Biostat, Glasgow G12 8QQ, Lanark, Scotland Univ Glasgow Glasgow Lanark Scotland G12 8QQ ow G12 8QQ, Lanark, Scotland
Titolo Testata:
AMERICAN JOURNAL OF EPIDEMIOLOGY
fascicolo: 6, volume: 154, anno: 2001,
pagine: 557 - 562
SICI:
0002-9262(20010915)154:6<557:OAEWTE>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
CLINICAL-TRIALS; ENDOSCOPIC TREATMENT; EPIDEMIOLOGY; OMEPRAZOLE; CARE; RISK;
Keywords:
anti-inflammatory agents; non-steroidal; cohort studies; drug evaluation; observation; pharmacoepidemiology; ulcer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: McMahon, AD Univ Glasgow, Robertson Ctr Biostat, Boyd Orr Bldg, Glasgow G12 8QQ, Lanark, Scotland Univ Glasgow Boyd Orr Bldg Glasgow Lanark Scotland G12 8QQ and
Citazione:
A.D. McMahon, "Observation and experiment with the efficacy of drugs: A warning example from a cohort of nonsteroidal anti-inflammatory and ulcer-healing drug users", AM J EPIDEM, 154(6), 2001, pp. 557-562

Abstract

Observational data are well suited for many types of medical research, especially when randomized controlled trials are inappropriate. However, some researchers have attempted to justify routine use of observational data in situations in which randomized controlled trials are normally conducted. Literature searches cannot be used to directly compare the results of the twotypes of research, because invalid observational studies normally are not publishable in the journal literature. The author created a study (1989-1994) to determine the efficacy of one exposure (ulcer-healing drugs) in preventing the serious upper gastrointestinal toxicity associated with another exposure (nonsteroidal anti-inflammatory drugs (NSAIDs)). A cohort of subjects from Tayside, Scotland, receiving both NSAIDs and ulcer-healing drugs appeared to experience a large rise in their risk of gastric bleeding and perforation (e.g., the rate ratio was 10.00 (95% confidence interval: 6.68, 14.97) when this cohort was compared with one receiving NSAIDs alone). This increased risk was due to confounding. Thus, use of a "restricted cohort design" was not able to eliminate uncontrollable bias. It is possible that if many different studies were carried outs then observational research would be found to be only occasionally useful for studying drug efficacy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 04:00:00