E-DRUG: Antipyretic drugs for children? (8)
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dear all
I do not want to argue on aspirin, because it is not popular any longer.
I am very much concerned about the ibuprofen which is increasingly popular
not only in US but also in Europe and other countries instead of
aspirin.
Ibuprofen is also available as one of many prescription NSAIDs
antipyretics including pranoprofen, dipyrone, mefenamic acid,
diclofenac to treat fever of children in Japan, though it is
not sold as an OTC drug in Japan.
By the way, as I received a criticism "What has become of EBM?"
saying it is strange to rely on case - control studies and animal
experiments to try to state that NSAIDs are more dangerous than
paracetamol.
I posted my comment:
"Could "desires" be evidence of higher level than a case-control study?"
One of the reasons why I thought the editorial's conclusion was strange
is that it did not deny the rationale of the combined treatment based
on the desires among parents and clinicians to do something when faced
with febrile children in the absence of evidence from controlled trials.
Could desires be evidence in evidence-based medicine (EBM)? If ever so,
are they of higher levels than a case-control study with outcome of
mortality and/or systematic review of animal experiments with outcome
of mortality when RCT with outcome of mortality or sever morbidity
has never been available?
ISDB manual stresses the importance of evidence level ranked by the
strength of endpoints. The manual was written by modifying a hierarchy
introduced by the US National Cancer Institute [3]: overall survival
is the strongest endpoint.
Please read the followings at:
http://bmj.bmjjournals.com/cgi/eletters/333/7557/4#138021
Kusuri-no-Check
Rokuro Hama
HAMA, Rokuro MD Chairman
NPOJIP: Non-Profit Organization "Japan Institute of Pharmacovigilance"
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