# \[e-drug\] Critical appraisal of advertisements **URL:** \ **Category:** e-drug\ **Created:** [March 29, 2001, 6:59am UTC](https://talk.edrugplus.org/t/e-drug-critical-appraisal-of-advertisements/10812 "2001-03-29T06:59:30Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![StaffanSvensson](https://dub1.discourse-cdn.com/flex013/user_avatar/talk.edrugplus.org/staffansvensson/32/351_2.png) [@StaffanSvensson](https://talk.edrugplus.org/u/StaffanSvensson)\ **Post date:** [March 29, 2001, 6:59am UTC](https://talk.edrugplus.org/t/e-drug-critical-appraisal-of-advertisements/10812/1 "2001-03-29T06:59:30Z")
E-drug: Critical appraisal of advertisements --------------------------------------------- Dear All, I have recently become responsible for a 5-week course in clinical trial methodology, at a course named the "Biomedical Drug Programme". As a subject of discussion, I showed the students an advertisement recently published in the Swedish Medical Journal (L�kartidningen), for GlaxoSmithKline's bupropion - Zyban (r). Have a look at [http://www.clinpharm.gu.se/bvlp/epid/buprop1.htm](http://www.clinpharm.gu.se/bvlp/epid/buprop1.htm) (click images to enlarge). The headline reads "Patients at risk that should stop smoking may now be treated effectively with a pill that affects [literally: works in] the brain". The task was to analyze this statement. I handed out the only available ad reference that seemed to have anything to do with the statement; A Controlled Trial of Sustained-release bupropion..., Jorenby et al, N Engl J Med 1999;340:685-91. Conclusions from our discussion were as follows: "Patients at risk": the NEJM article does not deal with patients at high risk, on the contrary, these were specifically excluded. The ad headline does not specify what risk the patients should be at, but it is implicit that high risk patients are the ones to treat. "should stop smoking": the treatment is voluntary, shouldn't it be "that want to stop smoking"? "a pill that affects the brain": all drugs for nicotine (or any other kind of ) dependence affect the brain, right? "may now treated effectively": this trial, where there does indeed seem to be some effect of bupropion, measures the efficacy (as measured in a randomized controlled trial), as opposed to the effectiveness (as measured in everyday practice), of the medication. The Swedish word "effektivt", "effectively" does not discern between efficacy and effectiveness, and the phrasing thus gives the impression that bupropion is proven to work well in usual practice. "treated effectively with a pill": the treatment was not only the medication but also a large number of counselling sessions by telephone and person-to-person. In all, there were 22 counselling sessions. It is doubtful whether such intense counselling is available in usual care. It would be interesting to get further comments from e-drug people regarding this ad! Staffan Svensson Dept of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden "Staffan Svensson" \ [Peter Mansfield of MaLAM might like to respond. BS] -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.