2021. Statins increase muscle pain or weakness at 1 y, with an absolute excess of 11 events/1000 person-y.
Cholesterol Treatment Trialists' Collaboration. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. Lancet. 2022;400:832-45. 36049498.
2022. In tobacco smokers with respiratory symptoms, a dual bronchodilator did not reduce symptoms at 12 wk.
Han MK, Ye W, Wang D, et al. Bronchodilators in tobacco-exposed persons with symptoms and preserved lung function. N Engl J Med. 2022;387:1173-84. 36066078.
2025. In rheumatic heart disease-associated AF, rivaroxaban increased adverse vascular outcomes vs. VKA at 3 y.
Connolly SJ, Karthikeyan G, Ntsekhe M, et al. Rivaroxaban in rheumatic heart disease-associated atrial fibrillation. N Engl J Med. 2022;387:978-88. 36036525.
2026. In type 2 diabetes, liraglutide reduced CV events at 5 y vs. glargine, glimepiride, or sitagliptin.
GRADE Study Research Group; Nathan DM, Lachin JM, Buse JB, et al. Glycemia reduction in type 2 diabetes-microvascular and cardiovascular outcomes. N Engl J Med. 2022;387:1075-88. 36129997.
2027. In type 2 diabetes, glargine and liraglutide each improved glycemic outcomes at 5 y vs. glimepiride or sitagliptin.
GRADE Study Research Group; Nathan DM, Lachin JM, Balasubramanyam A, et al. Glycemia reduction in type 2 diabetes-glycemic outcomes. N Engl J Med. 2022;387:1063-74. 36129996.
2028. In glucocorticoid-dependent polymyalgia rheumatica, tocilizumab improved a composite clinical outcome at 24 wk.
Devauchelle-Pensec V, Carvajal-Alegria G, Dernis E, et al. Effect of tocilizumab on disease activity in patients with active polymyalgia rheumatica receiving glucocorticoid therapy: a randomized clinical trial. JAMA. 2022;328:1053-62. 36125471.
2029. In cancer with dyspnea, high-dose dexamethasone did not improve dyspnea and increased SAEs.
Hui D, Puac V, Shelal Z, et al. Effect of dexamethasone on dyspnoea in patients with cancer (ABCD): a parallel-group, double-blind, randomised, controlled trial. Lancet Oncol. 2022;23:1321-31. 36087590.
2030. In type 2 diabetes, the BT-001 smartphone app reduced HbA1c more than a control app at 90 d.
Hsia J, Guthrie NL, Lupinacci P, et al. Randomized, controlled trial of a digital behavioral therapeutic application to improve glycemic control in adults with type 2 diabetes. Diabetes Care. 2022;45:2976-81. 36181554.
2031. In T1DM, open-source automated insulin delivery increased glucose time in target vs. sensor-augmented pumps.
Burnside MJ, Lewis DM, Crocket HR, et al. Open-source automated insulin delivery in type 1 diabetes. N Engl J Med. 2022;387:869-81. 36069869.
2033. Short-Term Adverse Outcomes After Mifepristone-Misoprostol Versus Procedural Induced Abortion : A Population-Based Propensity-Weighted Study.
Prior studies comparing first-trimester pharmaceutical induced abortion (IA) with procedural IA were prone to selection bias, were underpowered to assess serious adverse events (SAEs), and did not account for confounding by indication. Starting in 2017, mifepristone-misoprostol was dispensed at no cost in outpatient pharmacies across Ontario, Canada.
2036. Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians.
作者: Amir Qaseem.;Lauri A Hicks.;Itziar Etxeandia-Ikobaltzeta.;Tatyana Shamliyan.;Thomas G Cooney.; .;J Thomas Cross.;Nick Fitterman.;Jennifer S Lin.;Michael Maroto.;Adam J Obley.;Jeffrey A Tice.;Janice E Tufte.
来源: Ann Intern Med. 2023年176卷2期224-238页
This guideline updates the 2017 American College of Physicians (ACP) recommendations on pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults.
2037. Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians.
作者: Chelsea Ayers.;Devan Kansagara.;Brittany Lazur.;Rongwei Fu.;Amy Kwon.;Curtis Harrod.
来源: Ann Intern Med. 2023年176卷2期182-195页
The prevalence of osteoporosis is increasing in the United States.
2040. Assessing Performance and Clinical Usefulness in Prediction Models With Survival Outcomes: Practical Guidance for Cox Proportional Hazards Models.
作者: David J McLernon.;Daniele Giardiello.;Ben Van Calster.;Laure Wynants.;Nan van Geloven.;Maarten van Smeden.;Terry Therneau.;Ewout W Steyerberg.; .
来源: Ann Intern Med. 2023年176卷1期105-114页
Risk prediction models need thorough validation to assess their performance. Validation of models for survival outcomes poses challenges due to the censoring of observations and the varying time horizon at which predictions can be made. This article describes measures to evaluate predictions and the potential improvement in decision making from survival models based on Cox proportional hazards regression. As a motivating case study, the authors consider the prediction of the composite outcome of recurrence or death (the "event") in patients with breast cancer after surgery. They developed a simple Cox regression model with 3 predictors, as in the Nottingham Prognostic Index, in 2982 women (1275 events over 5 years of follow-up) and externally validated this model in 686 women (285 events over 5 years). Improvement in performance was assessed after the addition of progesterone receptor as a prognostic biomarker. The model predictions can be evaluated across the full range of observed follow-up times or for the event occurring by the end of a fixed time horizon of interest. The authors first discuss recommended statistical measures that evaluate model performance in terms of discrimination, calibration, or overall performance. Further, they evaluate the potential clinical utility of the model to support clinical decision making according to a net benefit measure. They provide SAS and R code to illustrate internal and external validation. The authors recommend the proposed set of performance measures for transparent reporting of the validity of predictions from survival models.
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