Daly C, Edwards H. Withdrawal of Digoxin in General Practice in Elderly Patients. Irish Medical Journal 1983;76(1):19-20
PubMed link: https://www.ncbi.nlm.nih.gov/pubmed/6826334
| Methods | Study design: Before-and-after study
Number of groups: One group |
| Participants | Number of participants: 15 enrolled, 15 completed
Age: 74.7 ± 9.0 years Gender: 9 female, 6 male Participants with dementia: No Inclusion criteria: · Sub-therapeutic digoxin levels Exclusion criteria: · Heart failure on examination Country: Scotland Setting; Community |
| Interventions | Medicine: Digoxin
Withdrawal schedule: Not described |
| Outcomes | Successful deprescribing
New incidences of heart failure New or increase prescription of diuretics |
| Dates | Study dates: Not described
Follow-upduration: One month |
| Funding sources | Not described |
| Notes |
Risk of bias table
| Bias | Authors’ judgment | Support for judgment |
| Random sequence generation (selection bias) | High risk | This was not a randomized study design. |
| Allocation concealment (selection bias) | 5 out of 5 | Not concealed – single group |
| Blinding of participants and personnel (performance bias) | 5 out of 5 | Not blinded – single group |
| Blinding of outcome assessment (detection bias) | High risk | As above |
| Incomplete outcome data (attrition bias) | Unclear risk | Limited detail |
| Selective reporting (reporting bias) | Unclear risk | Limited detail to assess this |
| Confounding (non-randomized) | 5 out of 5 | Before-and-after study design so no concurrent control. |
| Other bias | Unclear risk | Limited detail |
| Newcastle-Ottawa scale | ||
| Selection bias | Representativeness of the exposed cohort | Somewhat representative of the average population, but limited details to know. |
| Selection of the non-exposed cohort | There was no concurrent control group. | |
| Ascertainment of exposure | Ascertainment of exposure was through secure record. | |
| Demonstration that outcome of interest was not present at start of study | The researchers demonstrated that the outcome of interest was not present at the start of the study. | |
| Comparability bias | Comparability of cohorts on the basis of the design or analysis | The study controlled for digoxin use. |
| Outcome bias | Assessment of outcome | The outcome was assessedthrough record linkage. |
| Was follow-up long enough for outcomes to occur
|
The follow-up duration was probably inadequate for outcomes to occur. At least six months would have been necessary. | |
| Adequacy of follow-up of cohorts | Complete follow-up – all subjects accounted for | |
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