Harm: Clinical Scenario
You have been called to a meeting with the Health Authority Chief Executive to discuss concerns about long term effects of the oral contraceptive pill, particularly following a recent national pill scare. You formulate the question, in women using oral contraceptives: "What is the risk of death?"
Following the local librarian's advice, you search MEDLINE using the following text words (cohort$ and oral contraceptive$ and relative risk $).tw for the best quality cohort study you can find that specifically addresses the question of safety of the pill. Amongst a large number of much smaller studies using poorer quality designs, one recent study stands out in both size and duration ( BMJ 1999;318:96-100 ) which you download from the British Medical Journal's free website: http://www.bmj.com/.
Read the article and decide:
- Are the results of this harm study valid?
- Are the results of this harm study important?
- Should these valid, important results of this study about a potentially harmful treatment change the treatment of your population?