Wanted: More Subgroup Analyses and NNH
As a member of two subgroups (women and everyone over 65), I don’t
see how treatment guidelines, even those from New Zealand, can help
doctors and, in turn, individuals make an informed decision about lifelong
statin therapy. How evidence-based are any of these guidelines, for
example, when only nine of the 20 lipid-lowering drug trials that included
women have published their results by gender? 1
Dr. Manuel and colleagues suggest that treatment recommendations be
focused on people at the highest risk of heart disease, but the trend in
the U.S. is to label everyone high risk if he or she is over 65 and has
high cholesterol. Unless treatment guidelines take into consideration the
number needed to harm, especially overall deaths, they are misleading to
doctors and to the general public.
The public purportedly should not know how its laws and sausage are
made. I would suggest treatment guidelines be added to the list.
1 Diagnosis and treatment of coronary heart disease in women:
systematic reviews of evidence on selected topics. U.S. Agency for
Healthcare Research & Quality publication No. 03-0037, May 2003.
Competing interests: No competing interests