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Dealing with uncertainty about the effects of treatments

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Key points

  • Dramatic effects of treatments are rare
  • Uncertainties about the effects of treatments are very common
  • Small differences in the effects of different treatments are usual, and it is important to detect these reliably
  • When nobody knows the answer to an important uncertainty about the effects of a treatment, steps need to be taken to reduce the uncertainty
  • Much more could be done to help patients contribute to reducing uncertainties about the effects of treatments

Introduction

In this section we look at the uncertainties that almost invariably surround the claimed effects of treatments, whether new or old. For example, few would probably question the routine use of oxygen in people who have had a heart attack, yet there is no good evidence that it helps, and some evidence that it may cause harm. This uncertainty has never been adequately addressed [1] and many other effects of treatments are disputed.

NextDramatic treatment effects: rare and readily recognizable