How to Interpret New Data

  • Robert P. Heaney


  • Instead of relying mainly on personal experience with new diagnostic and treatment methods, a wise physician depends on studies reported in the medical literature.

  • Proof of efficacy of new agents is currently provided by double-blind, randomized, placebo-controlled trials (RCTs), generally involving more than one medical center.

  • Relative risk values alone give incomplete information. It is necessary to know also the basal risk of the outcome in question and to assess its importance, both medically and personally.

  • Cost/benefit analyses have become increasingly important in the development of practice guidelines, in the registration of drugs, and in the deployment of screening tests and preventive regimens.

  • The results of treatment trials of bone active agents must be analyzed in a way that is consistent with the underlying biology.

A physician tries a new bone active agent in his practice. His patients seem to improve and he is enthusiastic. Another physician, trying the same agent, sees little patient improvement but notes serious side effects and becomes convinced that the drug is more trouble than it is worth. Both are wrong, as the Hippocratic maxim suggests. It is impossible to say in individual cases how much of the difference between the two experiences is due to placebo effects, to variations in the biologic makeup of the patients concerned, or simply to random chance.


Bone Mass Endometrial Cancer Increase Breast Cancer Risk Random Chance Endometrial Cancer Risk 
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Further Reading

  1. Dowd R, Recker RR, Heaney RP (2000) Study subjects and ordinary patients. Osteoporos Int 11: 533–536.PubMedCrossRefGoogle Scholar
  2. Heaney RP (1991) How can we tell if a treatment works? Further thoughts on the randomized controlled trial. Osteoporos Int 1: 215–217.PubMedCrossRefGoogle Scholar
  3. Heaney RP (2001) Design considerations for clinical investigations of osteoporosis. In: Marcus R, Kelsey J, Feldman D (eds). Osteoporosis, 2nd edn, vol. 2. San Diego: Academic Press, pp.513–532.CrossRefGoogle Scholar
  4. Heaney RP (2001) The boneremodeling transient: interpreting interventions involvingbonerelatednutrients. Nutr Rev 59: 327–333.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2004

Authors and Affiliations

  • Robert P. Heaney

There are no affiliations available

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