By Gary Schwitzer
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 written by John Yudkin and posted by 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.
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.