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July 31, 1975New England Journal of Medicine

Measures of Clinical Efficacy

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Why the study?

What is the diagnostic accuracy and cost-effectiveness of intravenous pyelogram and iodohippuran renogram for renovascular hypertension?

Population

Representative hypertensive population and patients with renovascular hypertension

Design

Other

Authors

BMBarbara J. McNeilEast Tennessee State UniversityPVPaul D. VaradyCedars-Sinai Medical CenterBBBelton A. BurrowsBoston University

Discussion

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Implication

IVP screening risks high false positives, costs, and mortality; leaves open whether refined selection improves outcomes in renovascular hypertension.

Structured PICO

What is the diagnostic accuracy and cost-effectiveness of intravenous pyelogram and iodohippuran renogram for renovascular hypertension?

P
Population
Representative hypertensive population and patients with renovascular hypertension
I
Intervention
Hypertensive intravenous pyelogram and iodohippuran renogram
O
Outcome
Sensitivity, specificity, and cost-effectiveness for the diagnosis and surgical treatment of renovascular disease

Screening for and surgically treating renovascular hypertension is associated with high false-positive rates, significant surgical mortality, and massive population-level costs estimated at 10 to 13 billion dollars for the American population.

Cite This Study

McNeil et al. (1975) studied this question.

synapsesocial.com/papers/6a70cc7ec92390ac2d07d7a3https://doi.org/10.1056/nejm197507312930502
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clinical characteristics of renovascular hypertension1972 · 58 citations
  2. 2Renal Artery Stenosis and Hypertension: II. Mortality in Operated Patients Compared with the Mortality in Individually Matched Medically Treated Patients with Cryptogenetic Hypertension1970 · 17 citations
  3. 3Hypertension Control — The Challenge of Patient Education1973 · 26 citations
  4. 4Dollar Cost per Positive Test for Automated Multiphasic Screening1970 · 64 citations