Benefits and harms of drug treatments

doi:10.1136/bmj.329.7456.2

BMJ 2004;329:2-3 (3 July), doi:10.1136/bmj.329.7456.2

Editorial

Benefits and harms of drug treatments

Observational studies and randomised trials should learn fromeach other

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

However international medical science has become, communicatingelectronically at the speed of light, some fields are stillworlds apart. The movement that is subsumed under the bannerof evidence based medicine, with its sister movements such asthe Cochrane Collaboration or the BMJ's Clinical Evidence, aimsto evaluate whether the benefits of treatments that had beenhoped for actually exist. This relies almost exclusively onrandomised controlled trials, in particular in the study ofdrug interventions. In a world apart is the field of pharmacoepidemiology,devoting itself mainly to detection and systematic studies ofthe adverse effects of the very same treatments. Adverse drugeffects are often unanticipated and are predominantly investigatedby observational studies—for example, by using large databasesthat link routine prescriptions with the occurrence of unexpecteddisease.

The protagonists of these fields barely know each other: theypublish in different journals, write and read different books,. . . [Full text of this article]

Jan P Vandenbroucke, professor of clinical epidemiology

Department of Clinical Epidemiology, Leiden University Medical Centre, 1-C9-P, PO Box 9600, 2300 RC Leiden, Netherlands (j.p.vandenbroucke@lumc.nl)

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis: Julia Hippisley-Cox and Carol Coupland
BMJ 2005 330: 1366. [Abstract] [Full Text] [PDF]

Assessing the benefit-harm balance at the bedside: Yoon Kong Loke
BMJ 2004 329: 7-8. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Grypdonck, M. H. F. (2006). Qualitative Health Research in the Era of Evidence-Based Practice. Qual Health Res 16: 1371-1385 [Abstract]
Atthobari, J., Brantsma, A. H., Gansevoort, R. T., Visser, S. T., Asselbergs, F. W., van Gilst, W. H., de Jong, P. E., de Jong-van den Berg, L. T. W., on behalf of PREVEND study group, (2006). The effect of statins on urinary albumin excretion and glomerular filtration rate: results from both a randomized clinical trial and an observational cohort study. Nephrol Dial Transplant 21: 3106-3114 [Abstract] [Full text]
Papanikolaou, P. N., Christidi, G. D., Ioannidis, J. P.A. (2006). Comparison of evidence on harms of medical interventions in randomized and nonrandomized studies. CMAJ 174: 635-641 [Abstract] [Full text]
Chou, R., Helfand, M. (2005). Challenges in Systematic Reviews That Assess Treatment Harms. ANN INTERN MED 142: 1090-1099 [Abstract] [Full text]
Hippisley-Cox, J., Coupland, C. (2005). Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 330: 1366- [Abstract] [Full text]
Loke, Y. K. (2004). Assessing the benefit-harm balance at the bedside. BMJ 329: 7-8 [Full text]

Rapid Responses:

Read all Rapid Responses

Postmarketing surveillance is present in the UK, but under-used: John S Watts
bmj.com, 2 Jul 2004 [Full text]
Epidemiologists� long-term underestimation of harm from hormones: Ellen C G Grant
bmj.com, 3 Jul 2004 [Full text]
"Bangs for backfires" - a useful measure of benefits and harms? E.g. Rosuvastatin.: David R Purdy
bmj.com, 5 Jul 2004 [Full text]
Randomized controlled trials: the hijacking of basic sciences by mathematical logic: Vinod K Gupta, M.D.
bmj.com, 6 Jul 2004 [Full text]
Research and practice - two sides of same coin: Arun S Nanivadekar
bmj.com, 7 Jul 2004 [Full text]
Re: Randomized controlled trials: the hijacking of basic sciences by mathematical logic: Ellen C G Grant
bmj.com, 8 Jul 2004 [Full text]
Re: Re: Randomized controlled trials: the mythical hypomagnesaemia -- intrinsic noradrenergic activation -- cortical spreading depression nexus in migraine: Vinod K Gupta, MD
bmj.com, 8 Jul 2004 [Full text]
Re: Re: Re: Randomized controlled trials: the mythical hypomagnesaemia -- intrinsic noradrenergic activation -- cortical spreading depression nexus in migraine: Ellen C G Grant
bmj.com, 9 Jul 2004 [Full text]