How effective are common medications: a perspective based on meta-analyses of major drugs
Maybe the most important medical paper of the year!
Read this one very carefully!
"The vastness of clinical data and the progressing specialization of medical knowledge may lead to misinterpretation of medication efficacy."
"Medicine is becoming so highly specialized and the clinical literature is growing so fast, that few doctors let alone the lay public have a working knowledge of the detailed evidence on drugs outside their specialty [1]. This is despite the fact that clinicians must often evaluate comparative risks and benefits of treatments for patients with multiple maladies. Studies show that decision making can be distorted by various cognitive biases such as a physician’s tendency to remember dramatically successful cases and forget ones that failed or to misinterpret the statistical indices used in clinical trials and meta-analyses [2]. This may lead the physician to overestimate the efficacy of treatments, which in turn may be one of the causes of harmful overtreatment [3]."
"Among the seven outcomes that can be both objectively measured and are patient-oriented (marked in red color in Fig. 1) only one shows a big effect size [emphasisi added] (remission of reflux esophagitis by proton pump inhibitors [8])." Don't even get me started on proton pump inhibitors - they are a nightmare!
