06 January 2012

The New Therapeutics: Ten Commandments

Read, learn, implement. This is the best medical advice you will receive all year.

  1. Thou shalt treat according to level of risk rather than level of risk factor.
  2. Thou shalt exercise caution when adding drugs to existing polypharmacy.
  3. Thou shalt consider benefits of drugs as proven only by hard endpoint studies.
  4. Thou shalt not bow down to surrogate endpoints, for these are but graven images.
  5. Thou shalt not worship Treatment Targets, for these are but the creations of Committees.
  6. 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.
  7. Thou shalt honour the Numbers Needed to Treat, for therein rest the clues to patient-relevant information and to treatment costs.
  8. Thou shalt not see detailmen, nor covet an Educational Symposium in a luxury setting.
  9. Thou shalt share decisions on treatment options with the patient in the light of estimates of the individual's likely risks and benefits.
  10. Honour the elderly patient, for although this is where the greatest levels of risk reside, so do the greatest hazards of many treatments.

Originally formulated by Prof J Yudkin, From:
- it's well worth reading the full article.


    1. Excellent, if not as far-reaching as the original set :-D

    2. Stick around, Slicer - this is going to be one of the main themes of medicine in the 21st Century! So long as we can protect the NHS from the depredations of this crazy government, who really haven't a clue about what it's for :-)

    3. "Thou shalt apply a pinch of salt to Relative Risk Reductions ..."

      Aren't we supposed to cut down on salt? ;P