Proposed New Score to Rate the Strength of Evidence and Its Application to Large-Scale Clinical Trials of Angiotensin-Receptor Blockers
スポンサーリンク
概要
- 論文の詳細を見る
Background Many large-scale clinical studies appear to be interpreted with bias and with hindsight. To select the best treatment, accurate evaluation of randomized controlled trials (RCTs) and fair comparison of the results using the concept of evidence-based medicine are critical. A scoring system has been developed to rate the scientific strength of evidence and thereby provide guidance for best clinical practice and for large-scale RCTs of angiotensin-receptor blockers (ARBs). Method and Results Positive evidence scores (ESs) were given based on whether specified study endpoints were proven and whether treatments tested made significant progress over current usual therapy. Retrospective ad hoc analyses data were not counted, in order to simplify the system and to avoid hindsight interpretations, even in cases that were medically significant. In fact, in more than half of the large-scale trials with ARBs examined, ad-hoc analyses had been retroactively performed. When such post-hoc analyses were not used, the ESs were positive with candesartan and valsartan for treatment of heart failure, irbesartan and losartan for nephropathy and losartan for hypertension. Applying the ES system, losartan was judged to be an ARB with the strongest evidence covering a wide range of clinical relevance. Conclusion ES is useful for quantifying and comparing the strength of evidence obtained in large-scale RCTs of ARBs. Several problems related to rating the evidence obtained from clinical trials were recognized in this study.
- 社団法人日本循環器学会の論文
- 2006-08-20
著者
-
Yamazaki Tsutomu
Department Of Applied Chemistry Tokyo University Of Agriculture And Technology
-
Yamazaki Tsutomu
Department Of Clinical Bioinformatics Graduate School Of Medicine University Of Tokyo
-
Yamazaki Tsutomu
Department Of Applied Chemistry Graduate School Of Engineering Tokyo University Of Agriculture And T
関連論文
- PE-536 The Relationships between BNP and AF in Japanese Patients(PE090,Heart Failure (Biomarker) 2 (M),Poster Session (English),The 73rd Annual Scientific Meeting of the Japanese Circulation Society)
- DPE-013 Determinants of Medication and Clinical Outcome in Japanese Atrial Fibrillation Patients under Rate Control Strategy : From Shinken Database 2004-6(DPE03,Atrial/Supraventricular Arrhythmia (Clinical/Treatment) (A),Digital Poster Session (English),
- OE-381 Role of Atrial Fibrillation in Congestive Heart Failure : A Prospective Cohort Study of Shinken Database 2004-6(OE64,Heart Failure (Diagnosis) (M),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)
- OE-178 Comparison of Age-dependent Mortality between Patients with Cardiovascular Diseases and General Population in Japan(OE30,Preventive Medicine/Epidemiology/Education (H),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Japanese C
- OE-079 Role of AF in BNP-based Risk Stratification : From an Analysis of Cardiovascular Morbidity in Japanese Patients(OE14,Heart Failure (Biomarker) (M),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)
- OE-018 Occurrence of Warfarin Discontinuation and Its Determinants in Japanese AF Patients : From a Real-World Analysis(OE03,Thromboembolism/Antithrombotic Therapy/Thrombolysis (IHD),Oral Presentation (English),The 73rd Annual Scientific Meeting of The Ja
- OE-015 Effects of Warfarin on Mortality According to CHADS_2 Score and Components in Japanese AF Patients : From Shinken Database 2004-7(OE03,Thromboembolism/Antithrombotic Therapy/Thrombolysis (IHD),Oral Presentation (English),The 73rd Annual Scientific
- FRS-101 The Relationships between Estimated GFR and Prevalence of AF in Japanese Patients(FRS21,New Insights into Chronic Kidney Disease and Renal Circulation (H),Featured Research Session (English),The 73rd Annual Scientific Meeting of The Japanese Circu
- Japanese Randomized Trial for Investigation of a Combined Therapy of Amiodarone and Implantable Cardioverter Defibrillator in Patients With Ventricular Tachycardia and Fibrillation : The Nippon ICD Plus Pharmacologic Option Necessity (NIPPON) Study Design
- Body Size and Atrial Fibrillation in Japanese Outpatients
- Effects of Nicorandil on Cardiovascular Events in Patients With Coronary Artery Disease in The Japanese Coronary Artery Disease (JCAD) Study
- Gender Differences in Patients With Coronary Artery Disease in Japan : The Japanese Coronary Artery Disease Study (The JCAD Study)
- Elevated Serum Uric Acid is an Independent Predictor for Cardiovascular Events in Patients With Severe Coronary Artery Stenosis : Subanalysis of the Japanese Coronary Artery Disease (JCAD) Study
- OJ-160 Comparison of Risk Factors between Angiographically Diffuse versus Focal Stenosis in the Patients Enrolled in Japanese Coronary Artery Disease (JCAD) Study(OJ27,Coronary Circulation/Chronic Coronary Disease (Basic/Clinical) (IHD),Oral Presentation
- OE-390 Association between Angiographical Assessment of Luminal Narrowing and Recurrence of Cardiovascular Events : Substudy of Japanese Coronary Artery Disease (JCAD) Study(OE66,Atherosclerosis (Clinical/Pathophysiology) (IHD),Oral Presentation (English)
- FRS-087 The Impact of Diabetes on the Prognosis of Japanese Patients with Coronary Artery Disease(FRS18,New Insights into Metabolic Syndrome (H),Featured Research Session (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)
- Elevated Serum C-Reactive Protein Levels Predict Cardiovascular Events in the Japanese Coronary Artery Disease (JCAD) Study(Epidemiology)
- Demographics and Changes in Medical/Interventional Treatment of Coronary Artery Disease Patients Over a 3.5-Year Period in Japan : The Japanese Coronary Artery Disease Study: Trend Examination
- Rationale and Design of a Study to Examine Lower Targets for Low-Density Lipoprotein-Cholesterol and Blood Pressure in Coronary Artery Disease Patients : The Japanese Coronary Artery Disease Study II (JCADII)
- OJ-217 Genetic Variations of Mrf-2/Arid5B Confers Risk of Coronary Atherosclerosis in the Japanese Population(Genetics/Genetically engineered models/Gene therapy-2(H/M), The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PJ-482 The Polymorphism in the Adiponectin Gene is Associated with Susceptibility to Coronary Artery Disease(Atherosclerosis, clinical-11 (H) PJ81,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society
- Mechanism of Statin-Induced Myopathy Investigated Using Microarray Technology
- ATP binding Cassette Transporter (ABCA1) variant is one of the determinantsof plasma high density lipoprotein level in Japanese population
- Evidence for association of Ser326Cys polymorphism in 8-oxyguanin DNA glycosylase (OGG1) with susceptibility to coronary heart disease in Japanese
- The Matrix Metalloproteinase-1 (MMP-1) 1G/2G Polymorphism and the Matrix Metalloproteinase-3 (MMP-3) 5A/6A Polymorphism are Useful Genetic Markers for Myocardial Infarction
- Angiotensin II stimulation induces TGF β and its related proteins in cardiac fibroblasts
- Establishment of clinical data management system and its practical application to genetic epidemiology in cardiovascular medicine
- Cardiovascular clinical trials in Japan and controversies regarding prospective randomized open-label blinded end-point design
- Development of a Pioneering Clinical Support System Utilizing Information Technology : Clinical Informatics and Genome Analysis
- Genetic Variations of Mrf-2/Arid5b Confer Risk of Coronary Atherosclerosis in the Japanese Population
- Genetic Analysis in a Patient With Recurrent Cardiac Myxoma and Endocrinopathy
- Beta-Blocker Prescription Among Japanese Cardiologists and Its Effect on Various Outcomes
- The Significant Association of Genetic Polymorphisms in the KLF5 Gene with Coronary Artery Disease(Atherosclerosis, Clinical 9 (IHD), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Serum and cerebrospinal fluid levels of cytokines in acute encephalopathy associated with human herpesvirus-6 infection
- Morning home blood pressure may be a significant marker of nephropathy in Japanese patients with type 2 diabetes : ADVANCED-J study 1
- Superior Benefit of Aggressive Lipid-Lowering Therapy for High-Risk Patients Using Statins : the SUBARU Study : More Hypercholesterolemic Patients Achieve Japan Atherosclerosis Society LDL-C Goals with Rosuvastatin Therapy than with Atorvastatin Therapy
- OE-044 Baseline Data of JPPP : The Large Randomized Controlled Trial of Primary Prevention by Enteric Coated Low-dose Aspirin in Japan.(Atherosclerosis, clinical(01)(IHD),Oral Presentation(English),The 72nd Annual Scientific Meeting of the Japanese Circul
- FRS-102 Event rates of Japanese patients with atherothrombosis : Results from the REduction of Atherothrombosis for Continued Health (REACH) Registry(Clinical Frontiers in Atherosclerosis(IHD),Featured Research Session,The 72nd Annual Scientific Meeting o
- Prevalence, Awareness and Treatment of Cardiovascular Risk Factors in Patients at High Risk of Atherothrombosis in Japan : Results From Domestic Baseline Data of the REduction of Atherotherombosis for Continued Health(REACH) Registry
- PE-379 Lipid-independent Effects of Statins on Cardiovascular Events in the Japanese Coronary Artery Disease Study : Comparison Between Lipophilic and Hydrophilic Statins(Cardiovascular pharmacology, basic/clinical-3, The 71st Annual Scientific Meeting of
- Introduction of a New System for Conducting High-quality Clinical Studies(How to Make Japanese Original Evidence in Cardiology, The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- FRS-011 High-Mobility-Group Protein A2 Associates with the Smad Transcription Factors and Synergistically Promotes Cardiomyocyte Differentiation(Angiogenesis and Regeneration Medicine in Cardiovascular Medicine (M) : FRS3)(Featured Research Session (Engli
- Prognostic Effects of Combined Treatment With Calcium Channel Blockers and Statins in Patients With Coronary Narrowing : From the Japanese Coronary Artery Disease Study
- マイコプラズマにおけるブレイクポイントの考え方
- Bacterial propagation in reusable water reservoirs in a humidified oxygen supply system
- In vitro activity of β-lactams, macrolides, telithromycin, and fluoroquinolones against clinical isolates of Streptococcus pneumoniae : correlation between drug resistance and genetic characteristics
- The Significant Association of the Genetic Polymorphisms of Werner Helicase and β2 Adrenergic Receptor with Susceptibility to Coronary Heart Disease
- Hypertrophic Responses of Cardiomyocytes Induced by Endothelin-1 through the Protein Kinase C-Dependent but Src and Ras-Independent Pathways
- High-Mobility-Group Protein A2 Associates with Smad1, Activates the Csx/Nkx2-5 Gene Expression Cooperatively, and Promotes Cardiomyocyte Differentiation
- Diverse effects of homeobox transcription factor Csx/Nkx2-5 on cardiac myocytes
- IS037 Both Ca^2+/calmodulin-dependent kinase II and calcineurin play critical roles in cardiac hypertrophy
- 5 Establishment of clinical database system and identification of genetic factors contributing to the pathogenesis of atheroscherosis(Symposium 4 (SY4) (IHD) : Molecular Mechanism of Atherosclerosis)(Special Program)
- Proteinases Including MMPs Are Involved in the Pathogenesis of Aortic Aneurysm : A Study of the Transcription Profile with DMA Microarray
- Synthesis of Diamond by DC Plasrna Chemical Vapor Deposition above the Surface of a Water-Ethylene Glycol Solution
- 酸化スズガスセンサ膜の微構造およびホ-ル効果の膜厚依存
- Eicosapentaenoic Acid (EPA) in Reducing Secondary Cardiovascular Events in Hypercholesterolemic Japanese Patients
- IS029 Role of TNF-α in oxidative stress-induced apoptosis of cardiac myocytes
- Continuous Blockade of L-Type Ca^ Channels Suppresses Activation of Calcineurin nad Development of Cardiac Hypertrophy in Spontaneously Hypertensive Rats
- Statin Treatment for Patients With Paroxysmal Atrial Fibrillation : A J-RHYTHM Substudy
- Reversible Photoswitching Liquid-phase Adsorption on Azobenzene Derivative-grafted Mesoporous Silica
- Preparation of Hybrid Ordered Inorganic-Organic Mesostructures from an Asymmetrically Bridged Organic Precursor Containing Both Silanolate and Phosphonate
- Screening for Cardiac Dysfunction in Asymptomatic Patients by Measuring B-type Natriuretic Peptide Levels
- ガス中蒸発法による極端に多孔質な酸化スズ膜の作製
- 0099 ANGIOTENSIN II INDUCES PROTEIN KINASE C/RAF-1 KINASE/EXTRACELLULAR SIGNAL-REGULATED PROTEIN KINASE ACTIVATION INDEPENDENT OF SRC AND RAS IN CARDIAC MYOCYTES
- -0297- Isolation of Tyrosine Kinases from Adult Murine Heart(PROCEEDINGS OF THE 59th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY)
- Proposed New Score to Rate the Strength of Evidence and Its Application to Large-Scale Clinical Trials of Angiotensin-Receptor Blockers
- The Present Problems of Prospective Payment System by DPC Based on the Database of 26 University hospitals(Current Problems and Future Impact of the Diagnosis Procedure Combination and Related Payment System in Japan, The 69th Annual Scientific Meeting of
- 2 Present State and Issues of DPC-based Prospective Payment System based on University Hospitals Database(DPC and Clinical Practice of Cardiovascular Medicine, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- 高温X線回折を用いたCuInSe_2生成過程のその場観察
- Intensively Lowering Both Low-Density Lipoprotein Cholesterol and Blood Pressure Does Not Reduce Cardiovascular Risk in Japanese Coronary Artery Disease Patients
- Japanese Guidelines for the Management of Respiratory Infectious Diseases in Children 2007 with focus on pneumonia
- A construction of K-contact manifolds by a fiber join
- Effect of Intensive Lipid-Lowering Therapy With Rosuvastatin on Progression of Carotid Intima-Media Thickness in Japanese Patients : Justification for Atherosclerosis Regression Treatment (JART) Study
- Japan Prevention Trial of Diabetes by Pitavastatin in Patients with Impaired Glucose Tolerance (the J-PREDICT study) : rationale, study design, and clinical characteristics of 1269 patients
- A Multicenter Study Design to Assess the Clinical Usefulness of Semi-Automatic Measurement of Flow-Mediated Vasodilatation of the Brachial Artery
- Management of Home Blood Pressure by Amlodipine Combined With Angiotensin II Receptor Blocker in Type 2 Diabetes
- Effect of Groove Pattern of Chemical Mechanical Polishing Pad on Slurry Flow Behavior
- 2 Large-Scale Clinical Trials in Japan : The Experience in Japan Clinical Research Assist Center (JCRAC)(Roundtable Discussion 1 (RT1) (H) Clinical Megatrials in Japan : Present Status and Future Problems)(Special Program)
- Associations of variations in the MRF2/ARID5B gene with susceptibility to type 2 diabetes in the Japanese population
- 3 Establishment of clinical data management system and its practical application to genetic epidemiology in cardiovascular medicine(Symposium 5 (SY5) (IHD) : Genome Informatics of Cardiovascular System)(Special Program)
- The Effect of Losartan and Amlodipine on Left Ventricular Diastolic Function and Atherosclerosis in Japanese Patients with Mild-to-Moderate Hypertension (J-ELAN) study
- Perihepatic lymph node enlargement observed at a general health examination A cross-sectional study