At 17:29 05/10/1996 +1200, John wrote:
>I don't entirely agree with David Plews on this..
>For example David hasn't mentioned that age is the single most important
>risk factor, and the studies have only documented risks for MI/CAD.
I thought that the WOSCOPS study looked at primary prevention and death from
any cause? I could be wrong.
>The funding of the drugs is a totally separate issue.
Absolutely right, I was just trying to show the enormous importance and
implications of these trials. Not only will the drug bill increase, but just
think of the extra workload. Who is going to treat and monitor all these
people :-(
>My father is 72 years and if he had a cholesterol of 9 mmol/L I would most
>certainly be seeking treatment with the best EBM-medicine (EBM sometimes
>has its uses when the evidence is convincing).
This is the problem facing us. At what level of risk do you set the
treatment intervention level? 2% or 1%? For the later the increase in total
national drug bill is probably 50%. I think the trials evidence for over the
over 70s is not here yet, but extraploation of risk seems reasonable. If you
love your dad (or mum) then go for it.
--------------------------
Dr David J Plews
email: [log in to unmask]
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