BMJ 1999;319:380 ( 7 August )

Letters

Follow up care in general practice of patients with myocardial infarction and angina

    Trial was underpowered
    Author's reply

Trial was underpowered

The first 150 words of the full text of this article appear below.

EDITOR---The paper reporting the trial to improve follow up in general practice of patients with coronary heart disease after discharge from hospital is unduly pessimistic.1 At least one of the authors (Mant) has been in this situation before.

Mant worked on the OXCHECK study, which found comparable differences of less than 5% between control and intervention groups and in which a strategy identifying patients at high risk was abandoned in favour of targeting those with established disease at yet higher risk.2 It was left to Field et al to show that the OXCHECK study was successful and that the incremental addition of assessment of multiple risk factors to a pre-existing programme targeting smoking and blood pressure was a cost effective way of improving risk factors. 3 4

The failure to show substantial differences in outcomes in both Jolly et al's trial and the OXCHECK study has resulted from flaws in . . . [Full text of this article]
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Relevant Article

Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP)
Kate Jolly, Fiona Bradley, Stephen Sharp, Helen Smith, Simon Thompson, Ann-Louise Kinmonth, and David Mant
BMJ 1999 318: 706-711. [Abstract] [Full Text] [PDF]

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