Letters The treatment paradox

Not necessarily ...

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39465.508634.3A (Published 24 January 2008) Cite this as: BMJ 2008;336:174
  1. Norman R Williams, clinical trial co-ordinator
  1. 1Clinical Trials Group of the Department of Surgery, UCL Archway Campus, London N19 5LW
  1. n.williams{at}ctg.ucl.ac.uk

    Spence says that an individual patient, despite many years of investment in taking statins, gets virtually nil health benefit.1 This is not necessarily so. Clinical trials cannot determine if the benefit is confined to a few individuals or distributed among many. Statins might prevent (or delay) cardiovascular death in a handful of those who take them, or they might slightly reduce the risk in everyone who takes them.

    To use an analogy, wearing thermal underwear in winter might prevent death due to hypothermia in only a few, but the benefit of keeping warm would be felt by many.

    No conflict of interest is declared, as I do not take statins or wear thermal underwear.


    • Competing interests: None declared.


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