# E-DRUG: How to read a paper

**URL:** <https://talk.edrugplus.org/t/e-drug-how-to-read-a-paper/1243>\
**Category:** e-drug\
**Created:** [August 23, 1997, 12:52am UTC](https://talk.edrugplus.org/t/e-drug-how-to-read-a-paper/1243 "1997-08-23T00:52:07Z")\
**Posts on this page:** 1\
**Page:** 1

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**Author:** ![srahmad](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@srahmad](https://talk.edrugplus.org/u/srahmad)\
**Post date:** [August 23, 1997, 12:52am UTC](https://talk.edrugplus.org/t/e-drug-how-to-read-a-paper/1243/1 "1997-08-23T00:52:07Z")

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E-DRUG: How to read a paper  
---------------------------

Dear E-druggers,

Summary points from this week's article in the above series in  
the British Medical Journal follows:

Syed Rizwanuddin Ahmad  
Email: srahmad@essential.org  
----------------------------  
BMJ No 7106 Volume 315

Education and debate Saturday 16 August 1997  
How to read a paper

Papers that report drug trials  
Trisha Greenhalgh

This is the sixth in a series of 10 articles introducing  
non-experts to finding medical articles and assessing their  
value

"Evidence" and marketing

If you prescribe drugs, the pharmaceutical industry is interested  
in you and is investing a staggering sum of money trying to  
influence you. The most effective way of changing the prescribing  
habits of a clinician is through personal representatives (known in  
Britain as "drug reps" and in North America as "detailers"), who  
travel round with a briefcase full of "evidence" in support of their  
wares.

Pharmaceutical "reps" do not tell nearly as many lies as they used  
to (drug marketing has become an altogether more sophisticated  
science), but they have been known to cultivate a shocking ignorance  
of basic epidemiology and clinical trial design when it suits them.  
It often helps their case, for example, to present the results of  
uncontrolled trials and express them in terms of before and after  
differences in a particular outcome measure.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Summary points

Pharmaceutical "reps" are now much more informative than they  
used to be, but they may show ignorance of basic epidemiology and  
clinical trial design

The value of a drug should be expressed in terms of safety,  
tolerability, efficacy, and price  
&nbsp;&nbsp;  
The efficacy of a drug should ideally be measured in terms of  
clinical end points that are relevant to patients; if surrogate  
end points are used they should be valid  
&nbsp;&nbsp;  
Promotional literature of low scientific validity (such as  
uncontrolled before and after trials) should not be allowed to  
influence practice

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