Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners1996
Same information, different decisions: the influence of evidence on the management of hypertension in the elderly.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prescribers' Knowledge and Skills for Interpreting Research Results: A Systematic Review.The Journal of continuing education in the health professions · 2017Pooled it
- Using alternative statistical formats for presenting risks and risk reductions.The Cochrane database of systematic reviews · 2011Pooled it
- The effects of information framing on the practices of physicians.Journal of general internal medicine · 1999Pooled it
- Impact of short evidence summaries in discharge letters on adherence of practitioners to discharge medication. A cluster-randomised controlled trial.Quality & safety in health care · 2007Trial
- Can postponement of an adverse outcome be used to present risk reductions to a lay audience? A population survey.BMC medical informatics and decision making · 2007Trial
- A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.Journal of general internal medicine · 2003Trial
- Randomized trial evaluating the framing of cardiovascular risk and its impact on blood pressure control [ISRCTN87597585].BMC health services research · 2001Trial
- Review
- Article
- Formal comment on "Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease".PloS one · 2019Article
- Development of two shortened systematic review formats for clinicians.Implementation science : IS · 2013Article
- [Use and interpretation of the number needed to treat in urological practice].Der Urologe. Ausg. A · 2013Review
- Influence of framing and graphic format on comprehension of risk information among American Indian tribal college students.Journal of cancer education : the official journal of the American Association for Cancer Education · 2012Article
- Patient and general practitioner attitudes to taking medication to prevent cardiovascular disease after receiving detailed information on risks and benefits of treatment: a qualitative study.BMC family practice · 2011Article
- Providers' experiences treating chronic pain among opioid-dependent drug users.Journal of general internal medicine · 2009Article
- The "number needed to treat" turns 20--and continues to be used and misused.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2008Article
- Laypersons' understanding of relative risk reductions: randomised cross-sectional study.BMC medical informatics and decision making · 2008Article
- What do we know about communicating risk? A brief review and suggestion for contextualising serious, but rare, risk, and the example of cox-2 selective and non-selective NSAIDs.Arthritis research & therapy · 2008Review
- Randomized trial of the effect of research design and publication characteristics on physician change.Primary care companion to the Journal of clinical psychiatry · 2006Article
- Informed consent for mammography screening: modelling the risks and benefits for American women.Health expectations : an international journal of public participation in health care and health policy · 2005Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence-based medicine requires general practitioners (GPs) to act upon the results of clinical trials. Clinical trial evidence may be difficult to understand and apply in practice.
aimTo investigate whether GPs were unduly influenced in managing hypertension in the elderly by the ways in which benefits of trial results were presented, and to establish whether their current treatment of an elderly hypertensive patient was broadly in line with recent clinical trial evidence.
methodSeventy-three GPs attending a refresher course were given a written questionnaire containing data from one clinical trial of treatment of hypertension in the elderly presented in four different ways (absolute risk reduction, relative risk reduction, difference in event-free patients, and number of patients who had to be treated in order to prevent one clinical event), as if from four different trials. The effect of each presentation on treatment preferences was assessed using Likert scales. The results were analysed to determine whether the method of presentation of results influenced decision making. A clinical scenario was presented to investigate their current treatment preferences in an elderly hypertensive.
resultsAll GPs returned completed questionnaires. Relative risk reduction was the only presentation which was significantly different from the others, and was the most likely to influence prescribing. In free-text comments, 75% of GPs admitted having problems understanding statistics commonly found in medical journals. More than 90% conformed with recent clinical trial evidence for the management of hypertension.
conclusionGPs were most influenced by relative risk reduction, and were unaware of how the presentation of research results could affect treatment decisions. Most GPs freely admitted to difficulty in comprehending medical statistics. Almost all of the GPs expressed treatment decisions which were broadly in line with clinical evidence.
Indexed as
Identifiers
8978112PMC1239820What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.