The Newsroom    Published Thursday, Feb. 1, 2007, 5:17 PM
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Evidence is key when it comes to your treatment

Houston Chronicle, Feb. 1, 2007 Editor's note: Today marks the debut of the Houston Chronicle's new medicine column. Written by University of Texas Medical Branch physician Howard Brody, this weekly column will explore consumer medicine, research and bioethics. Dr. Brody is the director of UTMB's Institute for the Medical Humanities. His latest book is Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry. By Howard Brody Medical training programs, trying to prepare the physicians of tomorrow, focus a lot of attention now on something called "evidence-based medicine." Whenever I tell folks about this idea, they look at me funny. My brother, for example, thought a minute and replied, "What other kind of medicine is there?" So, allow me to tell you a story that goes back to 1989. Scientists knew two things back then. First, older people who had a certain kind of irregular heartbeat were much more likely to die of coronary disease. Second, a class of drugs was very good at reducing the number of irregular beats. So they designed a big research study, called CAST, to see whether giving those drugs to older, at-risk people saved lives. Some would have said, "Why even bother to do the trial? You can already tell in advance these drugs will be a good thing. Why not just go ahead and prescribe them?" CAST gave a clear-cut answer, all right, but it was the opposite of what everyone expected. They had to stop the study early because so many people getting the drugs were dying prematurely.



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