James P McCormack

James P McCormack
University of British Columbia - Vancouver | UBC · Faculty of Pharmaceutical Sciences

B.Sc.(Pharm), Pharm. D.

About

105
Publications
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2,104
Citations

Publications

Publications (105)
Article
Objective: To develop a clinical practice guideline to support the management of chronic pain, including low back, osteoarthritic, and neuropathic pain in primary care. Methods: The guideline was developed with an emphasis on best available evidence and shared decision-making principles. Ten health professionals (4 generalist family physicians,...
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Introduction Sleep-time blood pressure correlates more strongly with adverse cardiovascular events than does daytime blood pressure. The BedMed trial evaluates whether bedtime antihypertensive administration, as compared with conventional morning use, reduces major adverse cardiovascular events. Methods and analysis Design Prospective randomised,...
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Background Current heart failure (HF) guidelines recommend titrating angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and beta-blockers (BBs) to target doses used in pivotal placebo-controlled randomized controlled trials (RCTs). Despite a number of RCTs comparing different doses (i.e. higher versus lower doses)...
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Background While journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes a...
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Fully informed decisions cannot be made unless guidelines consider the effect of treatment on healthy life expectancy, say John S Yudkin and colleagues In a recently published case report titled “The tyranny of guidelines,” Sarosi recounts the story of an 86 year old man living on his farm in Wisconsin and caring for his 92 year old brother with...
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To the Editor Dr Asch and colleagues1 reported a randomized clinical trial using economic incentives to promote cardiovascular risk factor reduction. However, one of the tenets of behavioral economics is to design systems that are simple. By selecting low-density lipoprotein cholesterol (LDL-C) reduction as a part of the intervention, the authors c...
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Over the past decade, a large body of observational evidence has suggested an association between lower vitamin D status (25-hydroxyvitamin D) and multiple acute and chronic disorders, including cancer, multiple sclerosis, depression and respiratory tract infections. This evidence has fostered the hypothesis that increasing vitamin D intake may tre...
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When deciding on a treatment, the first diagnosis you need to reach is about the nature of the illness. The second diagnosis you need concerns what the individual would like to achieve.1 Both are of equal importance and this is as true in simple one-off encounters as in complex lifelong illness. But the balance needs particularly careful thought wh...
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Objective: To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focused...
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Background: Risk estimates for the same patient can vary substantially among cardiovascular risk calculators and the reasons are not fully explained. We compared the relative risk increases for consistent risk factors changes across different cardiovascular risk calculators. Methods: Five clinicians independently selected 16 calculators providin...
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Comment on: Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. [Diabetes Care. 2015]
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Since 2011, we’ve worked to create a dialogue between Canada’s journalists and academic health policy experts to enrich the quality and quantity of health policy stories in the Canadian media. We work with a Media Advisory Board made up of journalists and professors of journalism from across the country who let us know what their needs, constraints...
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To determine the quality of health recommendations and claims made on popular medical talk shows. Prospective observational study. Mainstream television media. Internationally syndicated medical television talk shows that air daily (The Dr Oz Show and The Doctors). Investigators randomly selected 40 episodes of each of The Dr Oz Show and The Doctor...
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To examine the nature of media coverage of vitamin D in relation to its role in health and the need for supplements. Media content analysis. Print articles from elite newspapers in the UK, the USA and Canada. 294 print newspaper articles appearing over 5 years (2009-2014). Newspaper coverage of vitamin D generally supported supplementation. The mos...
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To the Editor: The study by Gregg et al. (April 17 issue)(1) raises three concerns that we think may affect its conclusions. First, the broadening of the definition of diabetes in 1997 naturally leads to a dilution of severity over time and consequently fewer complications.(2) Second, the inability to separate type 1 and type 2 diabetes obscures th...
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Purpose of review: The cardiovascular benefit of many preventive interventions (like statins) is strongly dependent on the baseline cardiovascular risk of the patient. Many lipid and vascular primary prevention guidelines advocate for the use of cardiovascular risk calculators. Recent findings: There are over 100 cardiovascular risk prediction m...
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Controversies are common in medicine. Some arise when the conclusions of research publications directly contradict each other, creating uncertainty for frontline clinicians. In this paper, we review how researchers can look at very similar data yet have completely different conclusions based purely on an over-reliance of statistical significance an...
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Background: Use of cardiovascular disease risk calculators is often recommended by guidelines, but research on consistency in risk assessment among calculators is limited. Method and results: A search of PubMed and Google was performed. Five clinicians selected 25 calculators by independent review. Hypothetical patients were created with the use...
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This article develops the concept of probabilistic reasoning as one of the techniques clinicians use in making a diagnosis. We develop the concept that every question and every examination is a diagnostic test ultimately leading to a rule in or rule out of a diagnosis. We also develop the concept of pre-test probability pointing out that false posi...
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Purpose: A pharmacokinetic study in children to determine plasma flumazenil concentrations after the intranasal administration of 40 µg·kg−1. Methods: Following institutional approval and informed written consent, II ASA physical status I–II patients, aged two to six years, undergoing general anesthesia for dental surgery were recruited. After indu...
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Comprehensive education programmes can reduce antibiotic prescriptions, but the impact on clinical outcomes is unclear Over the past 70 years, antibiotics have influenced and improved the treatment of many symptomatic infections. Unfortunately, antibiotics produce side effects and—regardless of whether they are used appropriately or inappropriatel...
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For years, we and others have advocated starting treatment of chronic indolent conditions at doses lower than those typically recommended in the product monographs.1 The approach we recommend is to use a very low dose when starting a new medication if the condition is not life-threatening or producing severe symptoms. Unfortunately, this approach i...
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James McCormack and Michael Allan discuss issues and questions surrounding hsCRP measurements in patients.
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I agree with Finlay McAlister's analysis of the number needed to treat.1 However, I believe there is a missing issue associated with the use of the evidence-based terms we are so accustomed to using. Consider the following 2 scenarios. In the first scenario, a drug reduces the risk of dying from a myocardial infarction from 3% to 2% over 2–3 years...
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One of the hospital pharmacist’s many clinical roles is to estimate renal function, refer to literature references, and adjust medication doses for renal dysfunction. Use of the Cockcroft–Gault (CG) equation for this purpose has long been pharmacists’ “11th commandment”. Recently, however, the increasing availability of estimates of glomerular filt...
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To determine the degree to which current Canadian clinical practice guidelines (CPGs) for common chronic conditions (ie, diabetes, dyslipidemias, hypertension, and osteoporosis) discuss the importance of patients' values and preferences in therapeutic decision making, and provide quantitative information that would allow for comprehensive shared in...
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Knowledge pertaining to the effectiveness of smoking cessation treatments and patient characteristics that may affect success may enable smokers and clinicians to select individualized treatment for each patient and ultimately increase the success rate of smoking cessation in general. To evaluate the effectiveness of bupropion as a smoking cessatio...
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Objective: To assess the acceptability, utility, and effectiveness of evidence-based information guides for three conditions (sore throat, heartburn, or osteoporosis), designed with patient input, from the perspective of family physicians and community pharmacists. Method: A cross-sectional survey design was used. Fifty-three family physicians and...
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In a recent subset analysis of the Bezafibrate Infarction Prevention (BIP) trial, investigators looked at the effects of bezafibrate on patients with metabolic syndrome (MS).1 Tenenbaum et al1 reached the conclusions that “bezafibrate reduces the incidence of MI [myocardial infarction] in patients with metabolic syndrome during long-term follow-up,...
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Metformin has been used for over 40 years for patients with type 2 diabetes mellitus.1 With over 40 million patient-years of use as of 1999,1 there is now evidence that the drug decreases the risk of morbidity and death when used to treat type 2 diabetes.2 However, concern remains over the possible side effect of lactic acidosis, a condition with a...
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Editor—Decullier et al evaluated some of the factors influencing publication of health related research projects.1 They examined research activity outcomes from the perspective of research ethics approval. Registration of clinical trials is not universally required, and sponsor databases are necessarily limited in scope. However, approval by a res...
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Background A common and often integral method of delivering patient information is the use of patient guides. However, the acceptability, utility and impact of evidence-based therapeutic guides on physicians, pharmacists and patients have not been well evaluated. Methods This study was a prospective evaluation of 53 general practitioners' offices a...
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Patients routinely cite the media, after physicians and pharmacists, as a key source of information on new drugs, but there has been little research on the quality of drug information presented. We assessed newspaper descriptions of drug benefits and harms, the nature of the effects described and the presence or absence of other important informati...
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To describe what patients want to know about their medications and how they currently access information. To describe how physicians and pharmacists respond to patients' information needs. To use patients', physicians', and pharmacists' feedback to develop evidence-based treatment information sheets. Qualitative study using focus groups and a groun...
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A case in which a home peak expiratory flow (PEF) monitoring device was recommended led us to review the evidence examining this intervention. The clinical question to be answered was: should these devices be consistently recommended to all patients with asthma? A comprehensive search revealed eight randomized controlled trials, one review and one...
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As part of the health transition to obtain greater involvement of patients in treatment decision-making, this study sought to assess the acceptability and utility of evidence-based therapeutic information guides designed for patients. The guide reviewed therapeutic options for heartburn, sore throat, and osteoporosis. Patients from three regions of...
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The Canada Drug Guide Project tested the feasibility of producing evidence-based therapeutic guides in lay language and assessed the acceptability, utility, and impact of these guides on physicians, pharmacists, and patients. Methods: 53 family physicians in Nova Scotia, Ontario, and British Columbia recruited 10 patients to each of the prototypes:...
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Randomised trials are subject to interpretation bias as shown by the example of the UK prospective diabetes study. The UK prospective diabetes study shows no benefit on macrovascular end points in patients with type 2 diabetes treated with sulphonylureas or insulin over 10 years. The study shows a clinically important benefit on macrovascular end p...
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Randomised controlled trials are objective, free of bias, and produce robust conclusions about the benefits and risks of treatment, and clinicians should be trained to rely on them; so says the gospel of evidence based practice. In this article we argue, using the United Kingdom prospective diabetes study (UKPDS) as an example, that there is one st...
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To the Editor: In their article, Wilson et al1 provide useful information that allows clinicians to predict coronary heart disease risk in patients without a history of heart disease. This is very much needed because primary care and specialty physicians typically overestimate patients’ absolute heart disease risk and the expected benefits of dru...
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The way in which dissemination of evidence changes medical practice needs to be better understood. Controversy about calcium-channel blockers (CCB) in the past 3 years has provided a natural experiment, enabling assessment of the impact of media stories, a national warning letter, a teleconference, small group workshops, and newsletters on first-li...
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Editor—Freemantle et al’s editorial on the use of statins started a debate on treatment with cholesterol lowering drugs.1,2 The subsequent editorial by Muldoon and Criqui,3 and many of the letters on this issue,2 continued to focus on identifying a level of absolute risk reduction at which treatment of patients at risk of coronary heart disease wou...
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Long-term population-based studies have identified and quantified risk factors for cardiovascular and cerebrovascular (CCV) events. In addition, a number of well-designed clinical trials have shown that various drug therapies that reduce these factors decrease the risk of some CCV events. In the practice of evidence-based medicine, data from clinic...
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Although the recommended dose of rectal acetaminophen (25-30 mg.kg-1) is twice that for oral administration (10-15 mg.kg-1), the literature justifies the use of a higher dose when acetaminophen is administered via the rectal route. We measured venous plasma acetaminophen concentrations resulting from 45 mg.kg-1 of rectal acetaminophen in ten ASA 1,...