Learning to Deliver Better Health Care

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Description: Such limitations include the lack of any evidence on the efficacy or effectiveness of many interventions, the difficulty of extrapolating from trials carried out on selected populations to others (such as the elderly or those with multiple chronic conditions), and the growing recognition that the benefits of interventions vary substantially in different subgroups of the population included in the trials, with many lower risk patients experiencing little or no benefit (or even harm) and a relatively small subset receiving most of the benefits. Examples of the latter would include screening for prostate cancer (where patient attitudes toward the risks of treatment must be weighed against the still unproven benefits of screening) or percutaneous coronary interventions for stable angina (where the modest benefit in terms of angina relief must be weighed against the life-long need for antiplatelet therapy, among other risks).
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