And here are its tables of law
- 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 detailmen, 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.
Time for a little of that religion.
The list was published on Richard Lehman’s blog but it was written by John Yudkin.
We fully acknowledge and thank Gary Schwitzer’s health news watch dog , the Carlat Psychiatry Blog and the BMJ blogger Richard Lehman who led us to these sound and wise tables of law full of awareness.
These ten commandments stem from the wisdom of practitioners all along the years. My preferred one is the tenth: “Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.”
Because of my Confucians way of thinking?
And you, which is your preferred one?
If you want to read more:
- Get Your Doctor to Treat You Right: A Translation of “The Ten Commandments of the New Therapeutics” (psychologytoday.com)