[First-line treatment. What is lost by not giving it].
It is highly desirable to give always the best therapeutic alternative. However, the accomplishment of this goal is not always possible, leaving the physician with second, third or no therapeutic choice at all. The reasons for this may be economic, logistic, medical and cultural. In order to know what the patients are losing, we need to test how strong the scientific evidence is for the first choice option, and second, we have to consider the magnitude of improvement on clinical outcomes, comparing the best therapy and the next best available therapy. In many instances, the difference in clinical benefit is small and even negligible.
López-Jiménez
F
F
Harvard Medical School, Boston Massachusetts, USA.
Luna-Jiménez
M A
MA
D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D005062:European Union; D005069:Evaluation Studies as Topic; D017048:Health Care Costs; D006801:Humans; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D012306:Risk; D013812:Therapeutics / Q000191:economics / Q000592:standards