Exactly. But it used to be thought that beta-blockers were contraindicated in HF because they reduce cardiac output (the DOO) whereas, as you say, they actually help people with HF live longer (the POO).
I'm not suggesting, btw, that DOOs are always bad. Sometimes they are the best evidence we have. Just that we need to be cautious about over interpreting them or, worse still, letting control of the DOO (eg the persons LDL or HbA1c) become an end in itself.
Best wishes
Andy
----- Original Message -----
From: Cristian Baicus [mailto:[log in to unmask]]
Sent: Sunday, March 11, 2012 05:25 PM
To: Andy Hutchinson; [log in to unmask] <[log in to unmask]>
Subject: Re: Top 3 (or so) essential clinical epi concepts
sorry, but what do you mean by beta-blockers in HF? As I know, they prolong
life.
dr Cristian Baicus
www.baicus.ro
----- Original Message -----
From: "Andy Hutchinson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 11, 2012 7:22 PM
Subject: Re: Top 3 (or so) essential clinical epi concepts
Hi Hilda
I'd want to include the difference between disease oriented outcomes (DOOs
ie surrogates such as HbA1c, LDL, peak flow, etc) and patient oriented
outcomes (POOs) ie whether this treatment helps people live longer or
better. I'm sure members of this group can think of many examples of where
DOOs have misled eg rosiglitazone, torcetracib (that's a good one to look
at!), etc. And further back, beta blockers in HF, lidocaine in arrhythmias,
etc.
Cheers
Andy
Andy Hutchinson MEd, Pharmacist
Education and Development Manager
National Prescribing Centre
Provided by the National Institute for Health and Clinical Excellence
Ground Floor Building 2000 | Vortex Court | Enterprise Way | Wavertree
Technology Park | Liverpool L13 1FB
Tel:07824 604962
Web:www.npc.nhs.ukemail:[log in to unmask]
NICE Annual Conference 2012, 15-16 May, Birmingham, UK
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----- Original Message -----
From: Bastian, Hilda (NIH/NLM/NCBI) [C] [mailto:[log in to unmask]]
Sent: Saturday, March 10, 2012 04:25 PM
To: [log in to unmask]
<[log in to unmask]>
Subject: Top 3 (or so) essential clinical epi concepts
G'day!
I'm working on a list of top 3 (with top 5 and top 10 too) basic concepts
patients, journalists & clinicians need not to understand to protect
themselves from the data/health claims that commonly mislead. Would really
appreciate thoughts & all personal favourite lists like this.
At the moment my personal list goes like this:
1. Correlation vs causation
2. Relative risks without context
3. Increasing survival rates vs increasing length of life
Thoughts/resources gratefully received. (Have a great weekend!)
Many thanks!
Hilda
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