Atherosclerotic narrowing of the carotid arteries in asymptomatic individuals is associated with an increased risk of cerebrovascular ischemic events. The prevention of stroke in this context requires an understanding of the natural history of cerebrovascular atherosclerosis and the availability of an effective means for the detection and follow-up of carotid stenosis. / Methodological standards for the conduct and reporting of natural history studies of asymptomatic carotid disease are proposed and used to carry out a structured methodological appraisal of the literature. The findings suggest that greater attention should be paid to the design and statistical analysis of natural history studies. / A secondary analysis of the data from a natural history study of asymptomatic carotid disease is undertaken for the purpose of evaluating the prognostic usefulness of repeated duplex ultrasound examinations. Multivariable Cox proportional hazards models with fixed and time-dependent covariates are used to evaluate the predictive ability of carotid stenosis measurements obtained by duplex ultrasound at enrollment and during follow-up. The results of the analysis do not support the use of routine carotid ultrasound in clinical practice to determine prognosis for unselected patients with asymptomatic carotid disease.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.26665 |
| Date | January 1996 |
| Creators | Lewis, Rosamund F. |
| Contributors | Abrahamowicz, Michal (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001643447, proquestno: MQ37320, Theses scanned by UMI/ProQuest. |
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