8 research outputs found
Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease
BACKGROUND:
Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes.
METHODS:
We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization.
RESULTS:
During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events.
CONCLUSIONS:
Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)
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The economics of unit testing
Conventional wisdom and anecdote suggests that testing takes between 30 to 50% of a project's effort. However testing is not a monolithic activity as it consists of a number of different phases such as unit testing, integration testing and finally system and acceptance test.
Unit testing has received a lot of criticism in terms of the amount of time that it is perceived to take and its perceived costs. However it still remains an important verification activity being an effective means to test individual software components for boundary value behavior and ensure that all code has been exercised adequately. We examine the available data from three safety-related, industrial software projects that have made use of unit testing. Using this information we argue that the perceived costs of unit testing may be exaggerated and that the likely benefits in terms of defect detection are quite high in relation to those costs.
We also discuss the different issues that have been found applying the technique at different phases of the development and using different methods to generate those tests. We also compare results we have obtained with empirical results from the literature and highlight some possible weakness of research in this area
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Unit testing in practice
Unit testing is a technique that receives a lot of criticism in terms of the amount of time that it is perceived to take and in how much it costs to perform. However it is also the most effective means to test individual software components for boundary value behavior and ensure that all code has been exercise adequately (e.g. statement, branch or MC/DC coverage). In this paper we examine the available data from three safety related software projects undertaken by Pi Technology that have made use of unit testing. Additionally we discuss the different issues that have been found applying the technique at different phases of the development and using different methods to generate those test. In particular we provide an argument that the perceived costs of unit testing may be exaggerated and that the likely benefits in terms of defect detection are actually quite high in relation to those costs