Ten Commandments of “the new therapeutics”

Sometimes I blog things that I see just to ensure that I have a place to keep them.  This is one of those times. Because this is a keeper.

The Carlat Psychiatry Blog re-posted a list from BMJ blogger Richard Lehman – Ten Commandments for excellent clinical practice.

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 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.

Amen.

Time for a little of that religion.

Comments

Gary Schwitzer posted on January 8, 2012 at 10:20 am

Marilyn,

Thanks for your correction.

Please also note that Alice Dreger posted a laymen’s explanation of the “Ten Commandments” for those who may not be aware of some of the terminology.

http://www.psychologytoday.com/blog/fetishes-i-dont-get/201201/get-your-doctor-treat-you-right?page=2