The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Randomized Controlled Trials: Do They Have External Validity for Patients With Multiple Comorbidities?
Open accessAbstract
PURPOSE: Many randomized controlled trials (RCTs) exclude patients who have multiple comorbidities. The aim of this study was to illustrate the prevalence of comorbidities among patients followed up in primary care who would have met the inclusion criteria of selected RCTs focusing on treatment of a particular condition. We used hypertension as an example of a particular chronic condition. METHODS: We used an existing database of 980 patients (660 women) that was representative of a population consulting primary care family doctors and that contained information about all chronic conditions. We randomly selected 5 RCTs that focused on patients with hypertension. The inclusion and exclusion criteria used in each of the 5 RCTs were applied (1 study at a time) to the patients in our database. The patients from our data set who met the inclusion criteria of a given RCT were considered eligible for that RCT. RESULTS: Of the patients from our data set who were eligible for each of the RCTs, 89% to 100% had multiple chronic conditions. The mean number of chronic conditions of patients eligible for each RCT ranged from 5.5 +/- 3.3 to 11.7 +/- 5.3. CONCLUSIONS: Results from this study suggest that RCTs targeting a chronic medical condition such as hypertension could find that, in a sample taken from family practice, most eligible patients have comorbid conditions. Whether these patients are sampled or excluded should be reported. Research results intended to be applied in medical practice should take the complex reality of effective treatment of these patients into consideration.
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Hansson, L., Zanchetti, A., Carruthers, S. G., Dahlöf, B., Elmfeldt, D., Julius, S., Ménard, J., Rahn, K. H., Wedel, H., & Westerling, S. (1998) · The Lancet · doi:10.1016/s0140-6736(98)04311-6 · Cited by 5,728
The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2002) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.288.23.2981 · Cited by 5,664
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200101043440101 · Cited by 5,638
External validity of randomised controlled trials: “To whom do the results of this trial apply?”
Rothwell, P. M. (2005) · The Lancet · doi:10.1016/s0140-6736(04)17670-8 · Cited by 2,544
Wing, L. M. H., Reid, C. M., Ryan, P., Beilin, L. J., Brown, M. A., Jennings, G. L. R., Johnston, C. I., McNeil, J. J., Macdonald, G. J., Marley, J. E., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021716 · Cited by 1,130
Prevalence of multimorbidity among adults seen in family practice
Fortin, M. (2005) · The Annals of Family Medicine · doi:10.1370/afm.272 · Cited by 987
Self-citationIs There Time for Management of Patients With Chronic Diseases in Primary Care?
Ostbye, T. (2005) · The Annals of Family Medicine · doi:10.1370/afm.310 · Cited by 698
Cited by
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60240-2 · Cited by 6,972
Syndemics and the biosocial conception of health
Singer, M., Bulled, N., Ostrach, B., & Mendenhall, E. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30003-x · Cited by 1,491
Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A. (2013) · International Journal of Integrated Care · doi:10.5334/ijic.886 · Cited by 1,174
Kennedy-Martin, T., Curtis, S., Faries, D., Robinson, S., & Johnston, J. (2015) · Trials · doi:10.1186/s13063-015-1023-4 · Cited by 878
Defining and Measuring the Patient-Centered Medical Home
Stange, K. C., Nutting, P. A., Miller, W. L., Jaén, C. R., Crabtree, B. F., Flocke, S. A., & Gill, J. M. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1291-3 · Cited by 516
Metadata
- Authors
- Fortin, M.
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2006-03-01
- Volume
- 4
- Issue
- 2
- Pages
- 104-108
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- OpenAlex
- W2153988016
- Cited by
- 335
- References
- 8
- FWCI
- 9.96
- Type
- journal article
- Language
- en
- Open access
- diamond
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