The Painkiller Panic

“One of the most frustrating things about the latest news on painkillers is that almost none of the people reporting it understand the concept of relative risk–i.e., that a doubling of adverse events like heart attacks still doesn’t mean that event is very likely. A doubled risk might well be a chance worth taking, especially if the baseline risk is low to begin with and the drug’s benefits are significant for the patient in question. All of us implicitly accept this proposition with chemotherapy, for example, which poisons the entire body to kill a few cancer cells.

Why shouldn’t we look at painkillers the same way? If you suffered from disabling arthritis and understood that your baseline risk for heart attack or stroke over a given time period was less than 1%, you might be willing to accept a doubling to a mere 1.5%. That’s in fact what the study leading to the withdrawal of Vioxx in September found: 7.5 events per 1,000 in the placebo groups versus 15 per 1,000 among those taking the drug (and only after 18 months at a high dose).”

The Wall Street Journal warns against over-reaction and panic (via Medpundit).