Treating Individuals, From randomised trials to personalised medicine

Treating Individuals

From randomised trials to personalised medicine

Edited by Peter M. Rothwell, MBChB, MD, PhD, FRCP(London), Professor, Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK


Section 1: Reliable determination of the overall effects of treatments

1) Reliable assessment of the effects of treatment on mortality and major morbidity
2) The lethal consequences of failing to make full use of all relevant evidence about the effects of medical treatments: the importance of systematic reviews

Section 2: Is the trial relevant to this patient?

3) Assessment of the external validity of randomised trials
4) Applying results to treatment decisions in primary care
5) The older patient
6) Applying results to treatment decisions in complex clinical situations
7) External validity of pharmaceutical trials in neuropathic pain
8) External validity of pharmaceutical trials in asthma and chronic obstructive pulmonary disease

Section 3: Is the overall trial result sufficiently relevant this patient?

9) When should we expect clinically important differences in response to treatment?
10) Genes and the individual response to treatment
11) Reliable estimation and interpretation of the effects of treatment in subgroups
12) Can meta-analysis help target interventions at individuals most likely to benefit?
13) Use of risk models to predict the likely effects of treatment in individuals
14) Evaluating the performance of prognostic models
15) Are ?n-of-1? trials of any practical value to clinicians or researchers?

Section 4: Targeting of treatment in routine practice

16) Primary prevention of cardiovascular disease: the absolute risk-based approach
17) Antithrombotic therapy to prevent stroke in patients with atrial fibrillation
18) Reperfusion therapies in acute cardiovascular and cerebrovascular syndromes
19) Choice of agent in treatment of epilepsy
20) Pharmacogenomic targeting of treatment for cancer