Interpreting, Integrating, and Individualizing Evidence about the Prevention of Diabetic Nephropathy
Authors: Deborah J. Cook, Gordon H. Guyatt
Journal: Annals of Internal Medicine (1999)

Editorials2 November 1999Interpreting, Integrating, and Individualizing Evidence about the Prevention of Diabetic NephropathyDeborah J. Cook, MD, MSc(Epid) and Gordon H. Guyatt, MD, MSc(Epid)Deborah J. Cook, MD, MSc(Epid)McMaster University; Hamilton, Ontario L8N 4A6, Canada (Cook)McMaster University; Hamilton, Ontario L8N 4A6, Canada (Guyatt)Search for more papers by this author and Gordon H. Guyatt, MD, MSc(Epid)McMaster University; Hamilton, Ontario L8N 4A6, Canada (Cook)McMaster University; Hamilton, Ontario L8N 4A6, Canada (Guyatt)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-9-199911020-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Policy-relevant research for the care of patients with diabetes mellitus is in high demand, given the prevalence, morbidity, and costs associated with this condition. Randomized trials, meta-analyses, and economic studies have evaluated myriad management strategies directed at the diagnosis, prevention, and treatment of the macrovascular and microvascular sequelae of diabetes. Accordingly, diabetes mellitus is an ideal condition for evidence-based disease management (1, 2).A decision analysis reported in this issue focuses on prevention of diabetic nephropathy [3]. Golan and colleagues address this question: In patients with newly diagnosed type 2 diabetes mellitus, what is the relative impact on quality-adjusted life ...References1. Quickel KE Jr. Diabetes in a managed care system. Ann Intern Med. 1995; 124(1 Pt 2):160-3. Google Scholar2. Ellrodt G, Cook DJ, Lee J, Cho M, Hunt DL, Weingarten S. Evidence-based disease management. JAMA. 1997;278:1687-92. CrossrefMedlineGoogle Scholar3. Golan L, Birkmeyer JD, Welch HG. The cost-effectiveness of treating all patients with type 2 diabetes with angiotensin-converting enzyme inhibitors. Ann Intern Med. 1999;131:660-7. LinkGoogle Scholar4. Barratt A, Irwig L, Glasziou P, Cumming RG, Raffle A, Hicks N, et al . Users' guides to the medical literature. XVII. How to use guidelines and recommendations about screening. Evidence-Based Medicine Working Group. JAMA. 1999;281:2029-34. CrossrefMedlineGoogle Scholar5. Drummond MF, Richardson WS, O'Brien BJ, Levine M, Heyland D. Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 1997;277:1552-7. CrossrefMedlineGoogle Scholar6. Richardson WS, Detsky AS. Users' guides to the medical literature. XVII. How to use a clinical decision analysis. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 1995;273:1292-5. CrossrefMedlineGoogle Scholar7. O'Brien BJ, Heyland D, Richardson WS, Levine M, Drummond MF. Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. B. What are the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA. 1997;277:1802-6. CrossrefMedlineGoogle Scholar8. Richardson WS, Detsky AS. Users' guides to the medical literature. VII. How to use a clinical decision analysis. B. What are the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA. 1995;273:1610-3. CrossrefMedlineGoogle Scholar9. Ravid M, Brosh D, Levi Z, Bar-Dayan Y, Ravid D, Rachmani R. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial. Ann Intern Med. 1998; 128(12 Pt 1):982-8. Google Scholar10. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med. 1993;329:1456-62. CrossrefMedlineGoogle Scholar11. Siegel JE, Weinstein MC, Russell LB, Gold MR. Recommendations for reporting cost-effectiveness analyses. Panel on Cost-Effectiveness in Health and Medicine. JAMA. 1996;276:1339-41. CrossrefMedlineGoogle Scholar12. Udvarhelyi IS, Colditz GA, Rai A, Epstein AM. Cost-effectiveness and cost–benefit analyses in the medical literature: are the methods being used correctly? Ann Intern Med. 1992;116:238-44. LinkGoogle Scholar13. Fletcher SW. Evidence-based screening: what kind of evidence is needed? ACP J Club. 1998;128:A12-4. LinkGoogle Scholar14. Dowie J. ‘Evidence-based’, ‘cost-effective’ and ‘preference-driven’ medicine: decision analysis based medical decision making is the pre-requisite. J Health Serv Res Policy. 1996;1:104-13. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University; Hamilton, Ontario L8N 4A6, Canada (Cook)McMaster University; Hamilton, Ontario L8N 4A6, Canada (Guyatt)Note: Dr. Cook is a Career Scientist of the Ontario Ministry of Health.Current Author Addresses: Drs. Cook and Guyatt: Departments of Medicine and Clinical Epidemiology, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Cost-Effectiveness of Treating All Patients with Type 2 Diabetes with Angiotensin-Converting Enzyme Inhibitors Lubor Golan , John D. Birkmeyer , and H. Gilbert Welch Metrics Cited ByCost-effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in newly diagnosed type 2 diabetes in GermanyEstimation of mortality savings due to a national program for diabetes careUpdate in Nephrology and HypertensionPaul L. Kimmel, MDTechnology-Driven Interactive Care Management Identifies and Resolves More Clinical Issues than a Claims-Based Alerting SystemQuality of care and diabetes mellitusAngiotensin-converting enzyme inhibitors 2 November 1999Volume 131, Issue 9Page: 707-708KeywordsACE inhibitorsDecision analysisDiabetes preventionMicroalbuminuriaPatientsProteinuriaQuality of lifeRandomized trialsRenal failureType 2 diabetes Issue Published: 2 November 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...