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Full-Text Articles in Medicine and Health Sciences
The Chronic Kidney Disease Controversy: How Expanding Definitions Care Unnecessarily Labelling Many People As Diseased, Ray Moynihan, Richard Glassock, Jenny A. Doust
The Chronic Kidney Disease Controversy: How Expanding Definitions Care Unnecessarily Labelling Many People As Diseased, Ray Moynihan, Richard Glassock, Jenny A. Doust
Jenny Doust
Extract: In 2002 the United States Kidney Foundation launched a novel framework for defining and classifying chronic kidney disease. The framework was widely embraced because it imposed order in a chaotic landscape characterised by a variety of names, including renal insufficiency, renal impairment, and renal failure. It has had an appreciable effect on clinical care worldwide through guidelines, pay for performance measures, and sparked debate on the merits of screening programmes. However, it has also generated considerable controversy. We examine the rationale for the framework, the varying responses and controversies it has provoked, and provide advice for clinicians who are …
Prioritising Cvd Prevention Therapy - Absolute Risk Versus Individual Risk Factors, Jenny Doust, Sharon Sanders, Jonathon Shaw, Paul Glasziou
Prioritising Cvd Prevention Therapy - Absolute Risk Versus Individual Risk Factors, Jenny Doust, Sharon Sanders, Jonathon Shaw, Paul Glasziou
Jenny Doust
Background: Previous studies suggest that a high proportion of persons at high risk of cardiovascular disease in Australia are not receiving adequate disease prevention with blood pressure and lipid lowering therapy. However, it is not clear how a move to an absolute risk factor approach will affect the proportion of the population that is treated with blood pressure and lipid lowering therapy versus treatment based on individual risk factors. Methods: We classified participants in the AusDiab follow up cohort study who had no previous history of cardiovascular disease and who were not taking blood pressure or lipid lowering medication currently …
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Jenny Doust
Aims: Diagnosis of heart failure in primary care is often inaccurate, and access to and use of echocardiography is suboptimal. This study aimed to develop and provisionally validate a clinical prediction rule to optimize referral for echocardiography of people identified in primary care with suspected heart failure. Methods and results: A systematic review identified studies of diagnosis of heart failure set in primary care. The individual patient data for five of these studies were obtained. Logistic regression models to predict heart failure were developed on one of the data sets and validated on the others using area under the receiver …
Systematic Review Did Not Consider Problem Of Treatment Effects, Su May Liew, Jenny Doust, Paul Glasziou
Systematic Review Did Not Consider Problem Of Treatment Effects, Su May Liew, Jenny Doust, Paul Glasziou
Jenny Doust
Extract: Siontis and colleagues’ systematic review comparing established risk prediction models for cardiovascular disease is a useful validation of previous studies, but they seem to have ignored the problem of treatment effects.