Editor—Perhaps the BMJ would consider publishing PROSE as well as POEMs: pharmaceutical-driven research offering specious evidence.1
Preventing and treating influenza with “amivirs” would be an example.
Since these drugs are the subject of guidance from NICE in 1999 and 2000, as well as an editorial based on a NICE commissioned study, both in the BMJ of 7 June,2,3 patients and doctors might be forgiven for thinking they are helpful. Their proved benefit amounts to one day less (out of an average of six) of feeling unwell from flu when used as treatment and a reduced odds ratio for healthy subjects of getting flu when used as prevention: no fewer complications, no fewer deaths.
How were these clinically irrelevant results ever graced with NICE guidance? And how did the drugs attract the epithet of clinically effective based on these outcomes? This is the exact opposite of evidence that matters.
Most evidence that doesn't matter never sees the light of day. When it does, I hope that the BMJ will recognise it for what it is and PROSE it.
Competing interests: None declared.
References
- 1.Berger A. What do you think of the BMJ's POEMs? BMJ 2003;326: 1228. (7 June.) [Google Scholar]
- 2.Stöhr K. Preventing and treating influenza. BMJ 2003;326: 1223-4. (7 June.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Cooper NJ, Sutton AJ, Abrams KR, Wailoo A, Turner D, Nicholson KG. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials. BMJ 2003;326: 1235-40. (7 June.) [DOI] [PMC free article] [PubMed] [Google Scholar]