Guidance and/or Requirements for IM Journal Club
PreTest and/or Post-Test
September 20, 2017
Rivaroxaban with or without aspirin in stable cardiovascular disease. COMPASS Trial.
Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med. 2017.
Link to Presentation or Notes
Summary?
NNT = 77 ; NNH = 83
Implications for Clinical Practice?
Questions to ask yourself?
An Important Step for Thrombocardiology. NEJM Editorial. Braunwald, Eugene. August 27, 2017
Cardiovascular Outcomes for People Using Anticoagulation Strategies - COMPASS. Bavry, Anthony. August 27, 2017
The COMPASS Trial: Time for Clear Heads, Not Celebration. Mandrola, John. August 31, 2017. Medscape
CANTOS Trial. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease.
Ridker PM , Everett BM , Thuren T , et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med2017;377:1119-1131
Cox Regression
Proportional hazards regression, also called Cox regression, models the incidence or hazard rate, the number of new cases of disease per population at-risk per unit time
Cumulative Incidence
The proportion of individuals who experience the event in a defined time period
E(vent)/N(umber) during some time T(ime) = cumulative incidence
Double Dummy Trials
Double dummy is a technique for retaining the blind when administering supplies in a clinical trial, when the two treatments cannot be made identical.
Hazard Ratio
Interpretation
HR = 0.5: at any particular time, half as many patients in the treatment group are experiencing an event compared to the control group.
HR = 1: at any particular time, event rates are the same in both groups,
HR = 2: at any particular time, twice as many patients in the treatment group are experiencing an event compared to the control group.
Net Clinical Benefit
a quantitative framework that compares the overall change in the benefits and risks of a drug over a comparator.
http://protectbenefitrisk.eu/netclinicalbenefit.html