Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part B Therapy
Chapter 11.4. Surrogate Outcomes
Heiner C. Bucher, Regina Kunz, Deborah J. Cook, Anne Holbrook, Gordon Guyatt
Clinical Scenario
Topics Discussed:
angiotensin-converting enzyme inhibitors, diabetes mellitus, type 2, diabetic nephropathy, health outcomes, surrogate outcomes
Excerpt:
"You are an internist treating a 56-year-old woman with type 2
diabetes diagnosed about 5 years ago. The patient is obese (body
mass index, 29.5 kg/m2) and has difficulties adhering
to a recommended diet. Her glycosylated hemoglobin (HbA1c) during
the past 2 years has been reasonably well controlled (between 7.5% and
8.5%). She has repeatedly shown normal low-density lipoprotein
(LDL) cholesterol levels and blood pressure (<135/80
mm Hg), but at the last 2 visits you found a microalbuminuria level
of 200 mg per 24 hours. This raises your concern about the patient's risk of
developing end-stage renal disease (ESRD) like her sister with diabetes,
who is 8 years older...."
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