Guide |
Comments |
| I. Will the results help me in caring for my patients? | |
| 1. Can the results be applied to my patient care? | Yes |
| 2. Were all clinically important outcomes considered? | Sure looks like it! |
| 3. Are the likely benefits worth the potential harms and costs? | The treatment used in this study is relatively cheap (thiazides cost about $20 per year. The rate of adverse events (Table 7) was comparable between the two groups. They don’t report how many patients required potassium supplements. |
| II. Are the Results Valid? | |
| 1. Was the assignment of patients to treatments randomized? | After a run-in period, all subjects were randomized to receive either placebo or active treatment. |
| 2. Were all patients who entered the trial
properly accounted for and attributed at its conclusion? a) Was follow-up complete? |
Subjects were followed monthly until target BP reached, then quarterly. Table 2 summarizes the attrition over time. At the end of the third year of the study, over 95% of the participants were still in the study. |
| b) Were patients analyzed in the groups to which they were randomized | Yes (page 3258) |
| 3. Were patients, health workers, and study personnel "blind" to treatment? | Yes (page 3256) |
| 4. Were the groups similar at the start of the trial? | Table 1 shows the only statistically significant differences were in the pulse rate (70.3 vs. 71.3) and limitations in activities of daily living (95.4% independent vs 93.8% independent). You could make the argument that these differences, while statistically significant are clinically insignificant. |
| 5. Aside from the experimental intervention, were the groups treated equally? | Yes |
| III. What are the Results? | |
| 1. How large was the treatment effect? 2. How precise was the treatment effect? |
Table 6 summarizes the treatment effects The authors report confidence intervals for most events, stroke prevention and acute myocardial infarction were the only outcomes that did not overlap. |