Fonarow 2009.
| Methods | Study design: ITS | |
| Participants | Physicians Clinical speciality: not clear Level of training: fully trained Setting/country: hospital/inpatient/US |
|
| Interventions | The 4 PEMs were 2 published studies and 2 guidelines: 1. 4 April 2001, publication that statins produce early event reduction in ACS (MIRACL); 2. 22 March 2002, AHA/ACC Unstable Angina/Non‐STEMI guidelines recommending lipid‐lowering therapy before discharge in UA/non‐STEMI patients (ACC‐AHA‐NS); 3. 8 March 2004, publication that high‐dose statins superior in ACS to standard‐dose statins (PROVE IT‐TIMI 22); and 4. 4 August 2004, AHA/ACC STEMI guidelines recommending lipid‐lowering therapy before discharge in patients with STEMI (ACC‐AHA‐STEMI) | |
| Outcomes | 3 process outcomes:
|
|
| Notes | ‐ | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Intervention independent of other changes ‐ ITS | Unclear risk | No information is provided |
| Shape of Intervention effect pre‐specified ‐ ITS | Unclear risk | Quote, pg. 186: "it has not been well studied to what extent utilization of lipid lowering medications in patients with AMI has changed in response to more recent published clinical trial evidence and updates to national guidelines. In this study, the National Registry for Myocardial Infarction (NRMI) 3, 4, and 5 was used to examine national trends in the use of lipid‐lowering medications at discharge in patients hospitalized for AMI from 1998 to 2006" |
| Intervention unlikely to affect data collection ‐ ITS | Low risk | The interventions (MIRACL, ACC/AHA NSTEMI Guideline, PROVE IT‐TIMI 22, ACC/AHA STEMI Guideline) did not affect either the source or method of data collection |
| Blinding of outcome assessors (detection bias) ‐ ITS All outcomes | Low risk | Outcome was objective |
| Incomplete outcome data (attrition bias) ‐ ITS All outcomes | Low risk | National registries were used all along the study |
| Selective reporting (reporting bias) ‐ ITS | Low risk | All relevant outcomes in the methods section were reported in results section |
| Other bias ‐ ITS | Low risk | There was no evidence of other risks of bias |