Intended for healthcare professionals


Neuraminidase inhibitors for influenza

BMJ 2014; 348 doi: (Published 09 April 2014) Cite this as: BMJ 2014;348:g2548
  1. Harlan M Krumholz, Harold H Hines Jr professor of medicine
  1. 1Department of Internal Medicine, Yale University School of Medicine New Haven, CT 06510, USA; Department of Health Policy and Management, Yale School of Public Health; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital
  1. harlan.krumholz{at}

The whole truth and nothing but the truth

Informed choice requires comprehensive and credible information. Much of the rationale for the currently evolving movement to fully share data is to provide information for decision making, particularly in situations involving the need to balance the potential benefits and harms of medical products. This investment in data sharing is based on the premise that the value of the information from unavailable data is sufficiently meaningful to be worth the effort to make them available.1 Presumably, patients, with guidance from their doctors, might choose differently if data owners were to release all the information relevant to specific treatments and if independent scientists were able to properly analyze and communicate the results.

The publication of the most recent iteration of Cochrane reviews on the benefits and harms of oseltamivir and zanamivir, two neuraminidase inhibitors approved for the treatment of influenza, marks the first time that reviews of these products included information from all the pertinent clinical trials conducted by the manufacturers.2 3 Prior reviews could consider only a proportion of the studies that scientists had conducted with the drugs, since many were unpublished or selectively published. As a result of having much data out of public view, the prior reviews expressed substantial uncertainty about the benefits and harms of these antiviral agents, which led to repeated requests for all data to be …

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