Literature DB >> 7580661

Evidence based purchasing: understanding results of clinical trials and systematic reviews.

T Fahey1, S Griffiths, T J Peters.   

Abstract

OBJECTIVE: To assess whether the way in which the results of a randomised controlled trial and a systematic review are presented influences health policy decisions.
DESIGN: A postal questionnaire to all members of a health authority within one regional health authority.
SETTING: Anglia and Oxford regional health authorities.
SUBJECTS: 182 executive and non-executive members of 13 health authorities, family health services authorities, or health commissions. MAIN OUTCOME MEASURES: The average score from all health authority members in terms of their willingness to fund a mammography programme or cardiac rehabilitation programme according to four different ways of presenting the same results of research evidence--namely, as a relative risk reduction, absolute risk reduction, proportion of event free patients, or as the number of patients needed to be treated to prevent an adverse event.
RESULTS: The willingness to fund either programme was significantly influenced by the way in which data were presented. Results of both programmes when expressed as relative risk reductions produced significantly higher scores when compared with other methods (P < 0.05). The difference was more extreme for mammography, for which the outcome condition is rarer.
CONCLUSIONS: The method of reporting trial results has a considerable influence on the health policy decisions made by health authority members.

Entities:  

Mesh:

Year:  1995        PMID: 7580661      PMCID: PMC2551363          DOI: 10.1136/bmj.311.7012.1056

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  18 in total

1.  Absolutely relative: how research results are summarized can affect treatment decisions.

Authors:  L Forrow; W C Taylor; R M Arnold
Journal:  Am J Med       Date:  1992-02       Impact factor: 4.965

2.  Age as a predictor of outcome: what role does it play?

Authors:  T A Manolio; C D Furberg
Journal:  Am J Med       Date:  1992-01       Impact factor: 4.965

3.  Therapeutic priorities of Canadian internists.

Authors:  A Laupacis; D L Sackett; R S Roberts
Journal:  CMAJ       Date:  1990-02-15       Impact factor: 8.262

4.  Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials.

Authors:  N B Oldridge; G H Guyatt; M E Fischer; A A Rimm
Journal:  JAMA       Date:  1988-08-19       Impact factor: 56.272

5.  An assessment of clinically useful measures of the consequences of treatment.

Authors:  A Laupacis; D L Sackett; R S Roberts
Journal:  N Engl J Med       Date:  1988-06-30       Impact factor: 91.245

6.  Users' guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group.

Authors:  G H Guyatt; D L Sackett; D J Cook
Journal:  JAMA       Date:  1994-01-05       Impact factor: 56.272

7.  Evidence based policymaking.

Authors:  C Ham; D J Hunter; R Robinson
Journal:  BMJ       Date:  1995-01-14

8.  The number needed to treat: a clinically useful measure of treatment effect.

Authors:  R J Cook; D L Sackett
Journal:  BMJ       Date:  1995-02-18

9.  Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

Authors:  L Tabár; C J Fagerberg; A Gad; L Baldetorp; L H Holmberg; O Gröntoft; U Ljungquist; B Lundström; J C Månson; G Eklund
Journal:  Lancet       Date:  1985-04-13       Impact factor: 79.321

10.  Measured enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness?

Authors:  C D Naylor; E Chen; B Strauss
Journal:  Ann Intern Med       Date:  1992-12-01       Impact factor: 25.391

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  45 in total

1.  The ethics of alpha: reflections on statistics, evidence and values in medicine.

Authors:  R E Upshur
Journal:  Theor Med Bioeth       Date:  2001

Review 2.  Numbers needed to treat derived from meta-analyses--sometimes informative, usually misleading.

Authors:  L Smeeth; A Haines; S Ebrahim
Journal:  BMJ       Date:  1999-06-05

Review 3.  Risk communication in the patient-health professional relationship.

Authors:  S Buetow; J Cantrill; B Sibbald
Journal:  Health Care Anal       Date:  1998-09

4.  Simple tools for understanding risks: from innumeracy to insight.

Authors:  Gerd Gigerenzer; Adrian Edwards
Journal:  BMJ       Date:  2003-09-27

5.  Preventing stroke with ramipril. Results should have been presented in ways that help practising clinicians.

Authors:  P Badrinath
Journal:  BMJ       Date:  2002-08-24

6.  The role of evidence in health policy making: a normative perspective.

Authors:  Ole Frithjof Norheim
Journal:  Health Care Anal       Date:  2002

7.  How to make a silk purse from a sow's ear--a comprehensive review of strategies to optimise data for corrupt managers and incompetent clinicians.

Authors:  David Pitches; Amanda Burls; Anne Fry-Smith
Journal:  BMJ       Date:  2003-12-20

Review 8.  Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat.

Authors:  Alexandra Barratt; Peter C Wyer; Rose Hatala; Thomas McGinn; Antonio L Dans; Sheri Keitz; Virginia Moyer; Gordon Guyatt For
Journal:  CMAJ       Date:  2004-08-17       Impact factor: 8.262

9.  Bridging the gap between therapeutic research results and physician prescribing decisions: knowledge transfer, a prerequisite to knowledge translation.

Authors:  Jean-Pierre Boissel; Emmanuel Amsallem; Michel Cucherat; Patrice Nony; Margaret C Haugh
Journal:  Eur J Clin Pharmacol       Date:  2004-09-16       Impact factor: 2.953

Review 10.  Communicating risks at the population level: application of population impact numbers.

Authors:  Richard F Heller; Iain Buchan; Richard Edwards; Georgios Lyratzopoulos; Patrick McElduff; Selwyn St Leger
Journal:  BMJ       Date:  2003-11-15
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