The Indian registry on current patient profiles and treatment trends in hypertension (record): 1 year interim analysis to evaluate current clinical practices in Indian essential hypertensive patients

BACKGROUND Single-pill combination (SPC) in hypertension treatment has been recommended in guidelines for its benefits on improving blood pressure (BP) control and reducing adverse events (AEs) by simplifying treatment. OBJECTIVE To evaluate efficacy and safety of valsartan/amlodipine SPC on BP control in Chinese hypertensive patients in a real-life practice setting. METHODS This is a multicenter, open-label, observational study in Chinese hypertensive patients. Adults (18 and older) who were not at BP goal (<140/90 mmHg for uncomplicated patients, and <130/80 mmHg for patients with diabetes and chronic kidney disease) on monotherapy were eligible to the study. Patients were treated with valsartan/amlodipine 80/5 mg SPC and were followed over 8 weeks with approximately monthly intervals between clinic visits. For patients not achieving BP goal at week 4, other antihypertensives might be added. RESULTS A total of 11,879 patients were recruited into the study. In this interim analysis (from October 12, 2010 to October 11, 2011), a total of 4,609 patients were included. Among them, 39 were excluded due to violation of inclusion criteria, 20 discontinued (9 due to AEs). In total, 4,562 were included in the analysis. Mean age was 57.6 years, 7.1% (324 of 4562) of patients aged ≥80. Overall, mean BP was reduced from 159.7/95.6 mmHg at baseline to 132.0/80.3 mmHg at week 8 (-27.7/-15.3 mmHg, P<0.0001). The magnitude of BP reduction increased by severity of baseline BP. Blood pressure goal was achieved in 67.4% (3076 of 4562) of patients. In patients aged 80 or over, 65.1% (211 of 324) achieved BP goal. Add-on antihypertensives were prescribed in 6.2% (283 of 4562) of patients with diuretics the most often used. Adverse events were reported in 2.2% (99 of 4604) of patients. Edema was reported in 12 patients (0.3%). Three patients experienced serious AEs, of which none were trial drug related. In patients aged ≥80, AEs were reported in 1.2% (4 of 327) of patients, with 2 trial drug related AEs (0.61%), 1 of hypotension and 1 of flush. CONCLUSION In this 1 st largest observational study in Chinese hypertensive patients, the interim analysis results showed that valsartan/amlodipine SPC was effective and safe on BP control in Chinese patients, as well as in patients aged 80 and over.

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Bayesian Applications in Auditory Research

Journal of Speech Language and Hearing Research ◽

10.1044/2018_jslhr-h-astm-18-0228 ◽

2019 ◽

Vol 62 (3) ◽

pp. 577-586 ◽

Cited By ~ 9

Author(s):

Garnett P. McMillan ◽

John B. Cannon

Keyword(s):

Monte Carlo ◽

Markov Chain ◽

Bayesian Methods ◽

Prior Distribution ◽

Interim Analysis ◽

Iterative Process ◽

Bayes Theorem ◽

Sound Therapy ◽

The Many ◽

Auditory Research

Purpose This article presents a basic exploration of Bayesian inference to inform researchers unfamiliar to this type of analysis of the many advantages this readily available approach provides. Method First, we demonstrate the development of Bayes' theorem, the cornerstone of Bayesian statistics, into an iterative process of updating priors. Working with a few assumptions, including normalcy and conjugacy of prior distribution, we express how one would calculate the posterior distribution using the prior distribution and the likelihood of the parameter. Next, we move to an example in auditory research by considering the effect of sound therapy for reducing the perceived loudness of tinnitus. In this case, as well as most real-world settings, we turn to Markov chain simulations because the assumptions allowing for easy calculations no longer hold. Using Markov chain Monte Carlo methods, we can illustrate several analysis solutions given by a straightforward Bayesian approach. Conclusion Bayesian methods are widely applicable and can help scientists overcome analysis problems, including how to include existing information, run interim analysis, achieve consensus through measurement, and, most importantly, interpret results correctly. Supplemental Material https://doi.org/10.23641/asha.7822592

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Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

Perspectives on Gerontology ◽

10.1044/gero18.1.14 ◽

2013 ◽

Vol 18 (1) ◽

pp. 14-26 ◽

Cited By ~ 2

Author(s):

Rik Lemoncello ◽

Bryan Ness

Keyword(s):

Evidence Based Practice ◽

Single Case ◽

Quality Data ◽

Evidence Based ◽

Speech Language Pathology ◽

Clinical Practices ◽

High Quality ◽

Randomized Controlled Clinical Trials ◽

Relative Paucity ◽

Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

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