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November2, 1994
Andrew D. Oxman, MD, MSc; Deborah J. Cook, MD, MSc; Gordon H. Guyatt, MD, MSc; et al Eric Bass, MD, MPH; Patrick Brill-Edwards, MD; George Browman, MD, MSc; Allan Detsky, MD, PhD; Michael Farkouh, MD; Hertzei Gerstein, MD, MSc; Ted Haines, MD, MSc; Brian Haynes, MD, MSc; Robert Hayward, MD, MPH; Anne Holbrook, MD, PharmD, MSc; Roman Jaeschke, MD, MSc; Elizabeth Juniper, MCSP, MSc; Andreas Laupacis, MD, MSc; Hui Lee, MD, MSc; Mitchell Levine, MD, MSc; Virginia Moyer, MD, MPH; David Naylor, MD, DPhil; Jim Nishikawa, MD; Ameen Patel, MD; John Philbrick, MD; Scott Richardson, MD; Stephane Sauve, MD, MSc; David Sacked, MD, MSc; Jack Sinclair, MD; Brian Strom, MD, MPH; K. S. Trout, FRCE; Sean Tunis, MD, MSc; Stephen Walter, PhD; John Williams Jr, MD, MHS; Mark Wilson, MD, MPH
From the Departments of Clinical Epidemiology and Biostatistics (Drs Oxman, Cook, and Guyatt), Medicine (Drs Cook and Guyatt), and Family Medicine (Dr Oxman), McMaster University, Hamilton, Ontario.
JAMA. 1994;272(17):1367-1371. doi:10.1001/jama.1994.03520170077040
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Abstract
CLINICAL SCENARIO A 55-year-old man had his serum cholesterol level measured at a shopping mall 2 months ago. His cholesterol level was elevated and he comes to you, his primary care physician, for advice. He does not smoke, is not obese, and does not have hypertension, diabetes mellitus, or any first-order relatives with premature coronary heart disease (CHD). You repeat his cholesterol test and schedule a follow-up appointment. The test confirms an elevated cholesterol level (7.9 mmol/L [305 mg/dL]), but before deciding on a treatment recommendation, you elect to find out just how big a reduction in the risk of CHD this patient could expect from a cholesterollowering diet or drug therapy.
THE SEARCH There are a number of cholesterol-lowering trials, and instead of trying to find and review all of the original studies yourself, you use Grateful Med to find a recent overview. On the first subject line you
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Oxman AD, Cook DJ, Guyatt GH, et al. Users' Guides to the Medical Literature: VI. How to Use an Overview. JAMA. 1994;272(17):1367–1371. doi:10.1001/jama.1994.03520170077040
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