Annals of internal medicine
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In recognition of accelerating health care spending and alignment with the American College of Physicians (ACP) principles of promoting high-value care, the ACP Clinical Guidelines Committee (CGC) developed a framework to standardize its approach to identifying, appraising, and considering economic evidence in the development of ACP clinical guidelines. This article presents the CGC's process for incorporating economic evidence, which encompasses cost-effectiveness analyses, economic outcomes in randomized controlled trials, and resource utilization (intervention cost) data. Economic evidence is one component of ACP recommendations. The CGC first and foremost assesses the certainty of evidence for clinical net benefit of interventions; it then considers patient values and preferences, and only then considers economic evidence to develop recommendations.
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Reference tools are often uncritically accepted as balanced, objective, definitive, and evidence-based guides to medical knowledge. Yet for centuries textbooks and manuals have been entangled in various ways with industry interests. This essay shows how reference tools have served as sites of pharmaceutical promotion. ⋯ Merck leveraged its eponymous Manual initially to promote its own products and later to elevate its brand name amid a public relations storm. Purdue's influence on pain medicine textbooks and prescribing manuals was less direct: By subsidizing the creation of pain medicine's flagship textbook and cultivating goodwill from key leaders, the company shaped the direction of many of the field's reference tools. As reference tools evolve over the 21st century, combining in new ways with machine-learning models, a historical perspective alerts us to the enduring influence, and vulnerabilities, of these aids to thought.
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Comparative Study
Comparative Effectiveness and Safety of Atorvastatin Versus Rosuvastatin : A Multi-database Cohort Study.
Rosuvastatin and atorvastatin are the most widely prescribed moderate- to high-intensity statins. However, evidence on their efficacy and safety during actual use is limited. ⋯ National Key R&D Program of China and National Natural Science Foundation of China.