Five Questions to Ask About Drug Risk |
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."
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.
Adapted from an article by
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
How certain is the
How reliable and well-designed were the studies that revealed
Was it a small study? Was the association with a risk reproduced by
another research groups?
How big is the
"The incidence of the risk puts the issue in perspective." Is
the risk 1 in 50, or 1 in 1,000?
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."
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
Benefits Versus Risks