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May 31, 2007
Drugs have risks?
Interesting study highlighted in AMN this week. (Side note, on the website, the June 4 issue is already posted. News is an amazing business.) I don't have access to the journal Health Affairs but apparently the theme of the issue was health risks and benefits. One study by Peter J. Neumann, ScD, discussed mortality risks posed by drugs, work, transportation and recreation. They assessed risk in terms of fatality per 100,000 person-years engaged in that activity. Aspirin use, firefighting and car travel all fall about 10 or 11. Taxi driver and rock-climbing are both 36, with Clozapine at 35. "Helping patients, health care providers and policymakers understand the magnitude of drug risks is crucial to helping them make an informed decision when evaluating the risks and benefits of treatment," said Neumann.
This is certainly helpful information. But like much medical information, it is likely to be misused. First, this is only fatality risk. Evaluating the safety of aspirin involves more than fatality. Bleeding ulcers are (sometimes) painful, always messy affairs, with significant costs. Secondly, the comparisons are for "person-year" of participation. I am not sure how they count rock-climbing for instance. Is that hours spent climbing, or any climbing during that year? Thirdly, though they mention benefits, I wonder if the benefits are subjected to the same analysis. And are the incidences and mortality of the treated diseases dealt with?
Life is inherently risky. Sometimes it is helpful to know what those risks are. Sometimes, it is just background noise. How many people choose office work (0.4) over taxi driving (36) because it is less risky?
| By Robert Maddox | 04:48 PM