Richard Lehman в своем блоге
The New Therapeutics: Ten Commandments
• Thou shalt treat according to level of risk rather than level of risk factor.
• Thou shalt exercise caution when adding drugs to existing polypharmacy.
• Thou shalt consider benefits of drugs as proven only by hard endpoint studies.
• Thou shalt not bow down to surrogate endpoints, for these are but graven images.
• Thou shalt not worship treatment targets, for these are but the creations of committees.
• Thou shalt apply a pinch of salt to relative risk reductions, regardless of P values, for the population of their provenance may bear little relationship to thy daily clientele.
• Thou shalt honour the numbers needed to treat, for therein rest the clues to patient relevant information and to treatment costs.
• Thou shalt not see drug reps, nor covet an educational symposium in a luxury setting.
• Thou shalt share decisions on treatment options with the patient in the light of estimates of the individual’s likely risks and benefits.
• Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.
They circulated widely in various forms, and appeared in a modified form in The Good GP Training Guide. We have expanded them a little and hope to publish a new version soon, available in a number of formats. Stonecutters are being recruited as we speak.
