Pm. Layde et al., GENERALIZABILITY OF CLINICAL-STUDIES CONDUCTED AT TERTIARY CARE MEDICAL-CENTERS - A POPULATION-BASED ANALYSIS, Journal of clinical epidemiology, 49(8), 1996, pp. 835-841
Citations number
19
Categorie Soggetti
Public, Environmental & Occupation Heath","Medicine, General & Internal
The Marshfield Epidemiologic Study Area (MESA), a geographically defin
ed population registry at one of the participating sites in SUPPORT (a
multicenter study of the care of seriously ill hospitalized patients)
permitted assessment of generalizability in that study. On the basis
of age- and sex-specific rates of enrollment of SUPPORT patients in ME
SA, we estimate that about 400,000 patients per year would fulfill SUP
PORT eligibility criteria in the United States. However, an estimated
925,000 patients, particularly the elderly and those with impairments
in their activities of daily living (ADLs), have SUPPORT-like illnesse
s annually, but do not receive the aggressive care required for study
enrollment. The absence of patients not interested in aggressive care
in tertiary care-based studies is compounded by the overrepresentation
of patients referred from distant areas to the tertiary care center.
Such patients tended to be older and to have different diseases than p
atients in MESA. Care should be taken in generalizing results from cli
nical and epidemiologic studies conducted at tertiary care centers.