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      The Influence of Mortality Trials on the Evolution of Clinical Practice

      Cardiology

      S. Karger AG

      Cardiovascular disease, Clinical trials, Clinical practice, Audit, Marketing

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          Abstract

          Clinical practice is complex and is influenced by a number of factors such as time since medical qualification, opportunities for further education and peer review, as well as trial results and marketing. Systematic audit and peer review are powerful tools that are being used increasingly. When aided by the intelligent, but not Draconian, use of financial carrots they are an effective means of changing practice. Positive trials, such as those of thrombolytic therapy, have rapidly resulted in the widespread use of such treatment. Negative trials, for example those involving anti-arrhythmic prophylaxis after myocardial infarction or the use of calcium antagonists in patients with impaired left ventricular function, have also correctly resulted in an appropriate change in practice. Advertising does not always reflect best clinical practice and could lead to under-promotion of older but more useful drugs. Peer review and audit are probably the best available methods for promoting good clinical practice.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 84
          : 6
          : 413-419
          Affiliations
          John Radcliffe Hospital, University of Oxford, UK
          Article
          176433 Cardiology 1994;84:413–419
          10.1159/000176433
          8062307
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          Trials for Life: The Influence of Mortality Trials on the Evolution of Clinical Practice

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