PMID- 22742918
OWN - NLM
STAT- MEDLINE
DCOM- 20121001
LR  - 20151119
IS  - 1878-5921 (Electronic)
IS  - 0895-4356 (Linking)
VI  - 65
IP  - 9
DP  - 2012 Sep
TI  - A survey of physicians show a one-third reduction in harmful outcomes to be a 
      clinically important difference for statin therapy.
PG  - 954-61
LID - 10.1016/j.jclinepi.2012.02.019 [doi]
AB  - OBJECTIVE: To establish a minimal clinically important difference (MCID) for 
      outcomes of statin therapy with physicians using a cross-sectional design. The 
      MCID was defined as the smallest benefit of statin therapy that would result in 
      physicians recommending it to their patients after considering potential harm and 
      cost. STUDY DESIGN AND SETTING: A self-administered questionnaire was sent to 
      family practitioners, internal medicine specialists, and cardiologists practicing 
      in Hamilton. They provided an MCID of statin therapy using clinical scenarios 
      based on 5-year risk of vascular outcomes, namely coronary death, nonfatal 
      myocardial infarction, stroke, and coronary revascularization. RESULTS: Two 
      hundred nine physicians participated, of which 638 were initially approached. 
      Physicians would recommend statin therapy if it would at least reduce the 
      relative risk of vascular events by about one-third. For patient scenarios 
      involving a 30%, 13%, and 5% baseline risk of developing a vascular event in 5 
      years, physicians would recommend treatment if it would reduce the baseline risk 
      by 31.4% (standard deviation [SD], 19.8), 34.6% (SD, 18.0), and 46.2% (SD, 24.6), 
      respectively. CONCLUSION: Physicians were consistent in their choice of MCID for 
      statin therapy across vascular events. They required a larger benefit of statin 
      therapy for patients at a lower baseline risk (5%) of developing a vascular event 
      before they would recommend treatment.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Li, Kathy K
AU  - Li KK
AD  - Centre for Health Economics and Policy Analysis, CRL-210, McMaster University, 
      1280 Main Street West, Hamilton, Ontario, Canada L8S 4K1. likk2@mcmaster.ca
FAU - Holbrook, Anne M
AU  - Holbrook AM
FAU - Thabane, Lehana
AU  - Thabane L
FAU - Teo, Koon K
AU  - Teo KK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120627
PL  - United States
TA  - J Clin Epidemiol
JT  - Journal of clinical epidemiology
JID - 8801383
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
SB  - IM
MH  - *Attitude of Health Personnel
MH  - Cardiology/*standards
MH  - Cross-Sectional Studies
MH  - Family Practice/*standards
MH  - Female
MH  - Harm Reduction
MH  - Health Care Surveys
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
MH  - Internal Medicine/*standards
MH  - Male
MH  - Multivariate Analysis
MH  - Ontario
MH  - Practice Patterns, Physicians'
MH  - Reference Values
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2012/06/30 06:00
MHDA- 2012/10/02 06:00
CRDT- 2012/06/30 06:00
PHST- 2011/06/28 00:00 [received]
PHST- 2012/02/11 00:00 [revised]
PHST- 2012/02/19 00:00 [accepted]
PHST- 2012/06/30 06:00 [entrez]
PHST- 2012/06/30 06:00 [pubmed]
PHST- 2012/10/02 06:00 [medline]
AID - S0895-4356(12)00086-8 [pii]
AID - 10.1016/j.jclinepi.2012.02.019 [doi]
PST - ppublish
SO  - J Clin Epidemiol. 2012 Sep;65(9):954-61. doi: 10.1016/j.jclinepi.2012.02.019. 
      Epub 2012 Jun 27.