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Carotid endarterectomy for asymptomatic patients: assessing results of a quantitative synthesis.

Wortman PM; International Society of Technology Assessment in Health Care. Meeting.

Abstr Int Soc Technol Assess Health Care Meet. 1993; 9: 110.

Department of Psychology, State University of New York at Stony Brook.

BACKGROUND. The objectives of this study were: (1) to assess the safety and effectiveness of carotid endarterectomy (CE) for asymptomatic patients (2) by using a variant of meta-analysis called quantitative synthesis (QS) to summarize the results of the CE studies using non-randomized experimental designs. METHODS. A total of 214 scientific studies of CE reporting original data and written in English were retrieved using MEDLINE. Only 29 studies published from 1969-1988 reported findings on a total of 1676 asymptomatic patients. Data were extracted using a coding procedure developed by an expert panel. A total of 185 variables were coded per study. RESULTS. Overall, levels of mortality and morbidity were substantial (i.e., a 30-day aggregate of 3.6%). However, sharp differences were found between university and community hospitals. Multivariate analyses further revealed a statistically significant pattern of association between the use of a surgical shunt and lowered 30-day mortality and stroke-related morbidity. CONCLUSIONS. These results for CE on asymptomatic patients are somewhat hopeful, though preliminary in the context of inconsistent data reported in published studies. QS findings can be useful in both guiding future research and in designing new clinical trials.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Biomedical Research
  • Clinical Trials as Topic
  • Endarterectomy, Carotid
  • Evaluation Studies
  • Humans
  • Meta-Analysis
  • Stroke
  • methods
  • surgery
  • hsrmtgs
Other ID:
  • HTX/94906368
UI: 102211494

From Meeting Abstracts




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