Semin Med Pract
Applying evidence to the use of celecoxib in a patient with osteoarthritis: how to address clinical questions of harm
Feldstein DA, Chheda SG
This article, the latest in an ongoing series devoted to evidence-based medicine (EBM), examines the approach to addressing questions of harm. The aim of harm questions is to determine the effects of potentially harmful exposures (including physician-initiated therapies) on patient function, morbidity, and mortality. Using a case of a patient who is seeking a prescription for celecoxib to treat osteoarthritis pain, the authors discuss the study designs best suited to answering harm questions, how to appraise and apply the results of these studies, and the importance of establishing a patientís baseline risk for an adverse outcome in order to provide an estimate of the overall risk of the exposure.
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Updated 9/01/09 nvf