phoenix
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It's perfectly normal in this sort of analysis to use risk ratios . In the full paper, I suspect that Hooper and all will have followed their previous pattern and included http://handbook.cochrane.org/chapte...f_relative_effect_the_risk_ratio_and_odds.htm
When formulating guidelines the advice has to be at a population level and the sort of reduction in CVD events suggested is meaningful. You are right that overall mortality risk was not reduced at the level of death from all causes. In the relatively short time the controlled trials take place over, this is totally unsurprising.
CVD events are less likely to kill people than in the past because we are better at treating it. They are not benign on quality of life. They also lead to very expensive interventions
. (to put it on a personal level, the NHS must have paid many, many thousands to replace my father's aortic valve, put in stents and deal with several heart attacks, alter the rhythm of his heart, intervene when he's had embolisms and provide an ongoing cocktail of medications. I have seen wards full of men having undergone open heart surgery ,many of them very much younger than he)
You might also like to read the editorial by Rahul Bahl replying to Harcombe et al .This puts the results of meta analyses like this one in context. http://openheart.bmj.com/content/2/1/e000229.full#ref-13
When formulating guidelines the advice has to be at a population level and the sort of reduction in CVD events suggested is meaningful. You are right that overall mortality risk was not reduced at the level of death from all causes. In the relatively short time the controlled trials take place over, this is totally unsurprising.
CVD events are less likely to kill people than in the past because we are better at treating it. They are not benign on quality of life. They also lead to very expensive interventions
. (to put it on a personal level, the NHS must have paid many, many thousands to replace my father's aortic valve, put in stents and deal with several heart attacks, alter the rhythm of his heart, intervene when he's had embolisms and provide an ongoing cocktail of medications. I have seen wards full of men having undergone open heart surgery ,many of them very much younger than he)
You might also like to read the editorial by Rahul Bahl replying to Harcombe et al .This puts the results of meta analyses like this one in context. http://openheart.bmj.com/content/2/1/e000229.full#ref-13
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