In our article on cardiovascular primary prevention,1 we argue that the bar must be raised. A net clinical benefit should be demonstrated before novel agents are introduced into practice. We use overall mortality as a benchmark for this benefit. Wright and colleagues extend our claim, noting that morbidity must be taken into account. In principle, we agree with their comments. A drug that improves survival, but significantly worsens quality of life, would not constitute a net clinical benefit.
Prasad V, Vandross A. Raise the Bar Even Higher for Primary Prevention Interventions—Reply. Arch Intern Med. 2012;172(17):1352–1353. doi:10.1001/archinternmed.2012.3963
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