Comparative effectiveness research in heart failure therapies: women, elderly patients, and patients with kidney disease.
Comparative effectiveness research in heart failure therapies: women, elderly patients, and patients with kidney disease.
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DOI：
10.1016/j.hfc.2012.09.003
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发表时间：
2013-01
影响因子：
3.4
通讯作者：
Fonarow GC
中科院分区：
文献类型：
--
作者：
Shah RU;Chang TI;Fonarow GC
近几十年来，由于人口老龄化以及心血管疾病治疗和生存率的改善，心力衰竭（HF）的发病率和患病率增加。HF的发病率和死亡率很高，2006年有超过110万例出院，2007年有近350万例门诊就诊。2010年的直接和间接费用估计将近400亿美元。2随机对照试验（RCT）已经确定了有效的HF治疗方法，但这些试验中纳入的患者通常代表所有HF患者中的一个选定亚组。RCT参与者通常是男性，年轻，合并症较少且不太严重。相反，HF患者在日常实践中往往是老年人，女性，并与广泛的共病条件。3，4因此，人们面临着上述引文中描述的困境：如何确定对RCT中代表性不足的HF人群的有效治疗？
The incidence and prevalence of heart failure (HF) has increased during recent decades as a result of an aging population and improvements in treatment and survival of cardiovascular disease. Morbidity and mortality for HF are substantial, with more than 1.1 million hospital discharges in 2006 and almost 3.5 million outpatient visits in 2007. Estimated direct and indirect costs in 2010 amount to almost $40 billion. 2Randomized controlled trials (RCTs) have identified effective HF treatments, but the patients included in these trials often represent a select subgroup of all patients with HF. RCT participants are often male, young, and with fewer and less severe comorbid conditions. Conversely, HF patients in daily practice are often old, female, and with extensive comorbid conditions. 3, 4 Thus, one is left with the dilemma described in the quote above: How can one determine effective treatments for HF populations that are underrepresented in RCTs?
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