Sprague Word

The future and more from Richard Sprague

What works for one person may not work for another

Posted by sprague on July 9, 2012

 From The Atlantic piece about Larry Smarr:

In his book The Creative Destruction of Medicine, the physician-author Eric Topol cites such dosing as an example of medicine that is “population-based,” rather than “patient-centered.” He notes the widespread use of statins to lower LDL cholesterol, a factor in heart disease. Topol doesn’t deny the cholesterol-lowering effect of these drugs, but he argues that double-blind testing also shows that this effect benefits only a tiny fraction of those treated. One of the most effective statins, Crestor, has been found to reduce the incidence of stroke, heart attack, or death from 4 percent of patients in the placebo group to 2 percent of the group taking the statin. And yet these drugs are widely administered to patients considered at risk. Topol writes:


Instead of identifying the 1 person or 2 people out of every 100 who would benefit, the whole population with the criteria that were tested is deemed treatable … What constitutes evidence-based medicine today is what is good for a large population, not for any particular individual.


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