ArticleBMJ (Clinical research ed.)2006
Effectiveness and efficiency of different guidelines on statin treatment for preventing deaths from coronary heart disease: modelling study.
Article in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this mapPooled it
- Pooled it
- Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2011 · on this mapPooled it
- Performance of the Net Reclassification Improvement for Nonnested Models and a Novel Percentile-Based Alternative.American journal of epidemiology · 2018Article
- Hypercholesterolaemia - practical information for non-specialists.Archives of medical science : AMS · 2018Article
- Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study.Cardiovascular diabetology · 2016Observational
- Short-term predictive ability of selected cardiovascular risk prediction models in a rural Bangladeshi population: a case-cohort study.BMC cardiovascular disorders · 2016Article
- Guidelines helping clinicians make the GRADE.Internal and emergency medicine · 2015Article
- Article
- Who needs laboratories and who needs statins?: comparative and cost-effectiveness analyses of non-laboratory-based, laboratory-based, and staged primary cardiovascular disease screening guidelines.Circulation. Cardiovascular quality and outcomes · 2014Article
- Adherence to preventive statin therapy according to socioeconomic position.European journal of clinical pharmacology · 2013Article
- Cardiovascular risk.British journal of clinical pharmacology · 2012Review
- Is the high-risk strategy to prevent cardiovascular disease equitable? A pharmacoepidemiological cohort study.BMC public health · 2012Article
- Should risky treatments be reserved for secondary prevention? Theoretical considerations regarding risk-benefit tradeoffs.Journal of clinical epidemiology · 2012Article
- Improving the cost-effectiveness of cardiovascular disease prevention in Australia: a modelling study.BMC public health · 2012Article
- A population-based risk algorithm for the development of diabetes: development and validation of the Diabetes Population Risk Tool (DPoRT).Journal of epidemiology and community health · 2011Article
- Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.PloS one · 2011Article
- Coronary risk assessment by point-based vs. equation-based Framingham models: significant implications for clinical care.Journal of general internal medicine · 2010Article
- Knowledge creation: synthesis, tools and products.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2010Review
- Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America.Bulletin of the World Health Organization · 2010Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the potential effectiveness and efficiency of different guidelines for statin treatment to reduce deaths from coronary heart disease in the Canadian population.
designModelled outcomes of screening and treatment recommendations of six national or international guidelines--from Canada, Australia, New Zealand, the United States, joint British societies, and European societies.
settingCanada. DATA SOURCES: Details for 6760 men and women aged 20-74 years from the Canadian Heart Health Survey (weighted sample of 12,300,000 people) that included physical measurements including a lipid profile.
main outcome measuresThe number of people recommended for treatment with statins, the potential number of deaths from coronary heart disease avoided, and the number needed to treat to avoid one coronary heart disease death with five years of statin treatment if the recommendations from each guideline were fully implemented.
resultsWhen applied to the Canadian population, the Australian and British guidelines were the most effective, potentially avoiding the most deaths over five years (> 15,000 deaths). The New Zealand guideline was the most efficient, potentially avoiding almost as many deaths (14,700) while recommending treatment to the fewest number of people (12.9% of people v 17.3% with the Australian and British guidelines). If their "optional" recommendations are included, the US guidelines recommended treating about twice as many people as the New Zealand guidelines (24.5% of the population, an additional 1.4 million people) with almost no increase in the number of deaths avoided.
conclusionsBy focusing recommendations on people with the highest risk of coronary heart disease, the Canadian, US, and European societies guidelines could improve either their effectiveness (in terms of hundreds of avoided deaths) or efficiency (in terms of thousands of fewer people recommended treatment) in the Canadian population.
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