Association Between Clinician Computer Use and Communication With Patients in Safety-Net Clinics
Year: 2015
Type: article
Abstract: issue guidelines on the inclusion of women in clinical trials. 6 Given that KD is highly prevalent and may modify relevant parameters of some medications or procedures (eg, efficacy, safety, and pharmacokinetics), patients with KD should be included in cardiovascular trials in the absence of absolute contraindications.Investigators' goal should be to enroll a study population in which the prevalence and severity of KD match the prevalence and severity in the target population.Furthermore, investigators should consider stratifying treatment assignment based on kidney function to achieve balance and should report outcome and safety results stratified by level of baseline kidney function.What does widespread exclusion of patients with KD from cardiovascular trials mean for the practicing internist or nephrologist who must manage CVD in patients with KD? Unfortunately, the currently available randomized clinical trial data on the efficacy and safety of cardiovascular interventions in patients with KD is insufficient to make recommendations on the optimal approach for many therapies.This report underscores the need for greater inclusion of patients with KD in cardiovascular trials or the design of trials specifically focused on this population to better characterize the risks and benefits of cardiovascular interventions in this highly prevalent and prognostically important subgroup of patients.The number of randomized clinical trials within the field of nephrology is low, and the trials are of poor quality and are unlikely to provide adequate data on the treatment of CVD in patients with KD. 2 Extrapolation of trial results conducted in the general population to patients with KD may or may not be appropriate, and a deeper understanding of the barriers to including patients with KD in cardiovascular trials and the development of strategies to overcome them is urgently needed.
Source: JAMA Internal Medicine
Authors: Neda Ratanawongsa, Jennifer L. Barton, Courtney R. Lyles, Michael Wu, Edward H. Yelin, Diana Martinez, Dean Schillinger
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
Funders: GlaxoSmithKline, National Institutes of Health, Agency for Healthcare Research and Quality, Genentech, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Center for Advancing Translational Sciences
Awards: Prevalence and Impact of Frailty among Dialysis Patients, Facilitating Appropriate Analgesic Prescription in Hemodialysis Patients, ENGAGING DIVERSE PATIENTS IN USING AN ONLINE PATIENT PORTAL, G3316379059, G4674659540, Clinical and Transtional Science Institute, INTEGRATING ADHERENCE INTO A SAFETY NET EHR TOOL TO IMPROVE DECISION-MAKING, Goal concordance in rheumatoid arthritis in diverse populations, Diabetes Research and Engagement through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR)
OpenAlex ID: W2188041332