Alternative reports

doi:10.1136/bmj.a2331

Published 30 October 2008, doi:10.1136/bmj.a2331
Cite this as: BMJ 2008;337:a2331

Editor's Choice

Alternative reports

Jane Smith, deputy editor

jsmith@bmj.com

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

Nicholas Christakis thinks that pharmaceutical drugs are terrific—yetthey work only some of the time. Alastair Santhouse thinks thatpsychiatry is the noblest branch of medicine—yet it ischaracterised by dullness of thought and practice. Ike Iheanachothinks predictive models have provided countless advances inthe understanding of disease and treatment—yet they aretoo easily believed.

All three offer alternative ways of looking at familiar things.Christakis’s point is that doctors and patients have differentunderstandings of what it means to say that a drug "works" (doi:10.1136/bmj.a2281).Against the patient’s standard most drugs don’twork. "For example, sildenafil works less than half the time...only48% of men are found to respond to the drug compared with 11%who respond to a placebo." If a toaster didn’t toast breadevery time, most people would take it back to the shop. He arguesthat doctors should routinely evaluate patients’ responses. . . [Full text of this article]

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