BMJ 2000;321:1171-1172 ( 11 November )

Editorials

Pitfalls of pharmacoepidemiology

Oral contraceptive studies show a need for caution with databases

General practice p 1190

The first 150 words of the full text of this article appear below.

Three months ago a paper in the BMJ analysed the incidence of venous thromboembolism before and after the warning from the UK Committee on Safety of Medicines about third generation oral contraceptives.1 Using computer records of general practitioners, Farmer et al found that the incidence among pill users had not dropped, and they concluded that their findings were not compatible with a doubling of risk in women using third generation contraceptives (compared with older preparations). Their paper received wide publicity because it called into question an emerging consensus about this issue.2

This week's BMJ contains another analysis of computer records from British general practice, conducted by a group in Boston (p 1190).3 Jick et al found that, both before and after the warning in October 1995, the risk of venous thromboembolism in women using third generation oral contraceptives was about twice that in users of preparations containing levonorgestrel. Moreover, fewer . . . [Full text of this article]
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Risk of venous thromboembolism among users of third generation oral contraceptives compared with users of oral contraceptives with levonorgestrel before and after 1995: cohort and case-control analysis
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This article has been cited by other articles:

  • Wilks, J. F (2003). Hormonal Birth Control and Pregnancy: A Comparative Analysis of Thromboembolic Risk. The Annals of Pharmacotherapy 37: 912-916 [Full text]  
  • Skegg, D. C G (2002). Oral contraceptives, venous thromboembolism, and the courts. BMJ 325: 504-505 [Full text]  
  • Farmer, R., Williams, T., Nightingale, A. (2000). Pitfalls of pharmacoepidemiology. BMJ 321: 1352-1352 [Full text]  

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