Tuesday, November 04, 2008

THE LAWYERS ARE GETTING INTO THE ACT : STATINS FOR PRIMARY CAD PREVENTION IN WOMEN, RIGHT OR WRONG?

One of the interesting news that I read over the weekend was the presence of a Journal for empirical legal studies. Looks like the lawyers too have their review journals andin their latest journal is an article on whether the use of statins in primary CAD prevention in women, had any benefit. Suffice to say that the lawyers think not after a " thorough" review of the medical journals with the help of a medical statistician.
"Meta-analysis of leading randomized clinical drug trials finds no evidence that statins protect women against nonfatal myocardial infarction or fatal coronary heart disease in a primary-prevention context," write Eisenberg and Wells. "Unqualified advertising claims of protection against heart attacks therefore may be misleading. Existing legal doctrine supports the viability of state law claims based on questionable advertising." Dr Eisenberg and Mr Wells are the authors of the paper in the Journal of Empirical Legal Studies. When a lawyer gives a warning, I suppose we should take heed.
The long and short is that statins does not prevent CAD events in women without heart disease. That is the American legal position.
I suppose, they are right. From my understanding, it looks like statins for secondary prevention of CAD in males and females, is proper, correct and well accepted. Statins for the primary prevention of CAD in males has good evidence, but statins for primary prevention of CAD in women has little medical evidence, ppartly because, the numbers of females are so small, in most of the primary prevention trials, that it was difficult to draw a conclusion.
Well, if you have not got the gist of the message, " Doctors beware, lawyers are learning to look at your standards of care, and with the help of medical statisticians ".

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