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November 22/29, 2000

Helping Patients Integrate Research Evidence

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(20):2594-2595. doi:10.1001/jama.284.20.2591

To the Editor: In their article on integrating research evidence with the care of the individual patient, Dr McAlister and colleagues1 state, "Since your radiology department, in a recent audit, demonstrated that their ultrasonographic interpretations are highly correlated with angiographic results,2 you feel confident about their findings that both patients have moderate [carotid] stenoses. . . . " This conclusion is not supported by the cited reference, which concludes that "the results indicate that the accuracy of ultrasonography is moderate when flow parameters are used to assess the degree of stenosis. Ultrasonography should be used as a screening tool to exclude patients with no carotid artery disease from further testing. Conventional angiography remains an essential investigation before assigning the risk of stroke and deciding appropriate treatment. . . . "2

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