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Five Questions to Ask About Drug Risk | Resources
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When assessing the benefits and risks of prescribing a drug, doctors
consider the severity of the disorder being treated and the effect it is having on the person's quality of life.1
In general, the more serious the medical condition the more risk is acceptable for the intervention.
"Every drug has the potential to do harm as well as good. When doctors consider prescribing a drug, they must weigh the possible risks against the expected benefits.
... Use of a drug is not justified unless the expected benefits outweigh the possible risks. Doctors must also consider the likely outcome of withholding the drug. Potential benefits and risks can never be determined with mathematical precision." 1
In many cases there is no escaping risk, we exchange one kind for another - the tradeoff being: the risk of the disease untreated or under-treated, versus the risk of the treatment. For example, Higher risk therapy can be lower risk in the long term, if it leads to a durable remission and fewer needs to treat overall. Fortunately, for lymphoma the benefits of standard therapy often outweigh the risks.
Five Questions You Should Ask About Drug Risk
Adapted from an article by Harlan M. Krumholz MD, SM, is the Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University.
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How serious is the side-effect in question?
Sometimes the seriousness of the risk is small compared to the medical condition being treated.
For example: Is the side-effect reversible? Is it life threatening?
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How certain is the risk?
How reliable and well-designed were the studies that revealed the risk?
Was it a small study? Was the association with a risk reproduced by another research groups?
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How big is the risk?
"The incidence of the risk puts the issue in perspective." Is the risk 1 in 50, or 1 in 1,000?
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How great is the benefit of the drug?
"What is the drug doing for you? For drugs that have a risk, the benefit needs to be clear and strong."
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Are there good alternatives to the drug(s) in question?
"Even with this information, making these decisions is a bit like playing the lottery. You are betting that you will benefit from the drug or intervention. Amid all the uncertainties you must decide if the odds sound good to you - and that will depend on how you value the benefit and how much you fear the risk - and the likelihood of those events.
"Doctors cannot tell you what will happen. The best they can do is to be clear about what is known about the options -- and what remains uncertain."
Resources
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Benefits Versus Risks Merck
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