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Healthy Skepticism Library item: 1893

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Brotons C, Moral I, Ribera A, Cascant P, Iglesias M, Permanyer-Miralda G, Ferreira Gonzalez I, Soler-Soler J.
[Methods of reporting research-results and their influence on decision-making by cardiologists prescribing drugs for primary and secondary prevention.]
Rev Esp Cardiol 2002 Oct; 55:(10):1042-51


OBJECTIVES: To assess the influence of the form of presentation of the results of clinical trials on the quantitative perceptions of cardiologists regarding the efficacy of drugs for the primary and secondary prevention of coronary heart disease and their likelihood of prescribing them.

METHOD: We conducted a survey of 1,408 cardiologists in Spain who were randomly allocated of three questionnaires that used different measurements to evaluate the impact of published clinical trials.

RESULTS: Five-hundred and fifty-nine questionnaires (40%) were suitable for analysis. On a scale of 0 to 10, the following mean efficacy estimates were obtained from questionnaire items that focused, respectively, on the results of clinical trials in terms of relative risk reduction, absolute risk reduction, and number needed to treat: primary prevention with statins: 6.79, 6.38 and 5.43; primary prevention with aspirin: 6.84, 5.06 and 4.25; secondary prevention with statins: 8.16, 7.76 and 7.54; secondary prevention with ACE inhibitors: 7.11, 7.81 and 7.19, and secondary prevention with beta-blockers: 7.22, 7.43 and 6.98. The likelihood that a drug treatment would be prescribed was not influenced very much by the form of presentation of the trial results.

CONCLUSIONS: Presenting the results of clinical trials in the form of relative risk reduction, as compared with presenting results in terms of absolute risk reduction or number needed to treat, led to overestimation of the efficacy of interventions without influencing the likelihood of prescribing a given drug therapy.

Adrenergic beta-Antagonists/therapeutic use Adult Angiotensin-Converting Enzyme Inhibitors/therapeutic use Antilipemic Agents/therapeutic use Aspirin/therapeutic use Cardiology* Clinical Trials* Comparative Study Coronary Disease/prevention & control* Decision Making* English Abstract Female Fibrinolytic Agents/therapeutic use Humans Male Middle Aged Primary Prevention Questionnaires Random Allocation Risk Risk Factors


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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963