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I sometimes think that some of the problems arise because people think that there is always 'evidence' - it is quite possible that there is no evidence to support one view over another. While, as was said in a recent thread about the lack of funding for chiropractors looking at migraine, just asking the question and searching the literature is often insufficient. with respect to pharmacogenomics, the state of play at the moment is simply too 'lab based' to be of practical use. The best we can do at the moment is hope that second, third, etc generation drugs that have more refined activities, will lead to less associated problems in the form of adverse reaction. Let's face it, apart from allergic responses, side effects are generally due to the drug having effects away from its principle target for action. My final point - what may be statistically significant may not be clinically significant. For example, I am not interested in a difference of, say 3mmHg in blood pressure even with tight confidence intervals, when the study takes 3000 patients to demonstrate the effect. Dr Richard Phillips The Goffin Consultancy Ltd Riding House, Bossingham Road Stelling Minnis Canterbury, Kent CT4 6AZ United Kingdom Tel: +44 (0)1227 709220 Fax: +44 (0)1227 709721 Email: [log in to unmask] Web: www.goffin-network.co.uk