A cohort, or follow-up study design seems, since the landmark Framingham Heart study(1), to be the best study design for identifying risk factors for increased, all-cause, cardiovascular disease mortalities, dementia in general, Alzheimer disease in particular, so-called type 2 diabetes, and some other non-communicable chronic diseases(2).
Charles Darwin has shown that all living species on earth have to pass through evolutionary survival in nature and print to the next generations the best genes for that (3). In the context of evolutionary laws, so far as the poet and songwriter, Bob Dylan, has composed: “the times they are a changin”….
The big advantage of the randomization process is controlling for confounders that we are not even aware were present at a given particular time. And that is why a well done prospective randomized clinical trial is considered the gold standard of evidence-based medicine.
In the present case, and in my humble opinion, it is urgently needed to do the best by comparing light to moderate alcohol drinking with active comparators such as non-alcoholic beer and non-alcoholic liquors, using balanced primary and secondary outcomes. This is because of this sort of “new but opposite” information to what has been so far established as “common sense” by large and repeated observational evidence as the “J” curve of survival all-cause and cardiovascular benefits of light to moderate drinking (4) is now presented in this study of Topiwala et al.
3. George C. Williams, Randolph M. Nesse. The Dawn of Darwinian Medicine. The Quaterly Review of Biology March 1991.
4. Peter L Thompson , MD, FRACP, FACC. J-curve revisited: cardiovascular benefits of moderate alcohol use cannot be dismissed. Medical Journal of Australia. May 6th. 2013. doi: 10.5694/mja12.10922.
Competing interests:
No competing interests
09 June 2017
Jose Mario F. de Oliveira
Associate Professor of Medicine
Department of Medicine. Universidade Federal Fluminense
Rua Senador Vergueiro " 2 Apt. 202. Rio de Janeiro, 22230-001; Brazil.
Rapid Response:
Try the best we can for a gold standard.
A cohort, or follow-up study design seems, since the landmark Framingham Heart study(1), to be the best study design for identifying risk factors for increased, all-cause, cardiovascular disease mortalities, dementia in general, Alzheimer disease in particular, so-called type 2 diabetes, and some other non-communicable chronic diseases(2).
Charles Darwin has shown that all living species on earth have to pass through evolutionary survival in nature and print to the next generations the best genes for that (3). In the context of evolutionary laws, so far as the poet and songwriter, Bob Dylan, has composed: “the times they are a changin”….
The big advantage of the randomization process is controlling for confounders that we are not even aware were present at a given particular time. And that is why a well done prospective randomized clinical trial is considered the gold standard of evidence-based medicine.
In the present case, and in my humble opinion, it is urgently needed to do the best by comparing light to moderate alcohol drinking with active comparators such as non-alcoholic beer and non-alcoholic liquors, using balanced primary and secondary outcomes. This is because of this sort of “new but opposite” information to what has been so far established as “common sense” by large and repeated observational evidence as the “J” curve of survival all-cause and cardiovascular benefits of light to moderate drinking (4) is now presented in this study of Topiwala et al.
REFERENCES:
1. https://www.framinghamheartstudy.org/
2,http://www.joslin.org/info/Type_2_Diabetes_Know_Your_Risk_Factors.html
3. George C. Williams, Randolph M. Nesse. The Dawn of Darwinian Medicine. The Quaterly Review of Biology March 1991.
4. Peter L Thompson , MD, FRACP, FACC. J-curve revisited: cardiovascular benefits of moderate alcohol use cannot be dismissed. Medical Journal of Australia. May 6th. 2013. doi: 10.5694/mja12.10922.
Competing interests: No competing interests