Jaeschke R, Oxman A D, Guyatt G H
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Am J Med. 1990 Mar;88(3):279-86. doi: 10.1016/0002-9343(90)90154-6.
To reappraise the effectiveness of digoxin for the treatment of congestive heart failure (CHF) in patients with sinus rhythm in light of data from recently published randomized controlled trials and to quantitatively assess its usefulness.
Computerized searches of the MEDLINE database were performed, and the reference list of each retrieved article was reviewed.
Review of more than 360 citations and the reference lists of 19 review articles and 61 potentially relevant articles revealed seven double-blind randomized controlled trials that were included in this overview.
Study quality was assessed and descriptive information concerning the study populations, the specific interventions, and clinically relevant outcome measurements was extracted.
The common odds ratio for CHF deterioration while receiving digoxin versus placebo was 0.28, with a 95% confidence interval of 0.16 to 0.49. Predictors of digoxin benefit included presence of a third heart sound and the severity and duration of CHF.
Data from seven trials of high methodologic quality suggest that, on average, one out of nine patients with CHF and sinus rhythm derive a clinically important benefit from digoxin (with a 95% confidence interval of 1/33 to 1/5).
根据最近发表的随机对照试验数据，重新评估地高辛对窦性心律的充血性心力衰竭（CHF）患者的治疗效果，并定量评估其效用。
对MEDLINE数据库进行计算机检索，并查阅每篇检索文章的参考文献列表。
回顾360多篇文献引用以及19篇综述文章和61篇潜在相关文章的参考文献列表，发现七项双盲随机对照试验纳入本综述。
评估研究质量，并提取有关研究人群、具体干预措施和临床相关结局测量的描述性信息。
接受地高辛治疗与接受安慰剂治疗相比，CHF恶化的共同优势比为0.28，95%置信区间为0.16至0.49。地高辛获益的预测因素包括第三心音的存在以及CHF的严重程度和持续时间。
七项方法学质量较高的试验数据表明，平均而言，每九名CHF窦性心律患者中有一名从地高辛中获得临床上重要的益处（95%置信区间为1/33至1/5）。
