Weighing the benefits and harms of treatments can be tricky. There are lots of different things to consider. Follow the example below to learn what some of these things are and how you might use them to make a decision about treatment. Imagine that you are 65 and have just had a mild stroke. An artery that supplies your brain with blood and oxygen is blocked. Your doctor has searched through the medical research and wants to discuss your choices for treatment with you.The doctor tells you that you could have surgery or you could take an aspirin every day to get rid of the blockage.There is a type of research study called a

 

 

 

 

 

randomized controlled trials
Randomized controlled trials are medical studies designed to test whether a treatment works. Patients are split into groups. One group is given the treatment being tested (for example, an antidepressant drug) while another group (called the comparison or control group) is given an alternative treatment. This could be a different type of drug or a dummy treatment (a placebo). Researchers then compare the effects of the different treatments.

 

 

 

 

 

randomized controlled trial. This type of study compares the different options for treatment in patients with the same condition. For example, it might compare surgery with aspirin for patients who have had a stroke. In your case, research has found that five years after having surgery 5 percent of patients had another stroke. But it also found that five years after taking aspirin, 5 percent of patients had another stroke.

 

 

 

 

 

Source:
Hayden M, Pignone M, Phillips C, Mulrow C.
Aspirin for the Primary Prevention of Cardiovascular Events: Summary of the Evidence
Ann Int Med 2002;136(2):161-72

 

 

 

 

 

¹ When there is no clear-cut answer, it can be difficult to make a decision.(For more information about the different types of studies, see How to pick the best research studies).So you need to consider other things as well. Your doctor says that you also need to think about the risk of complications from surgery. About 2 percent of patients who have surgery die from the procedure. The risk varies according to the surgeon's skill. Some surgeons have better results than others.What should you do? What extra information do you need?

• You need to consider how healthy you are. If you have other serious medical conditions, the risks from surgery may be greater.
• You need to find out how many of these procedures your surgeon has done and what the results of the surgery have been. Have they been successful? Have the patients made a full recovery? The surgeon's results are sometimes tricky to understand because they may depend on the health of the people who were operated on. People who are healthier are more likely to make a full recovery.
• You will probably also want to know whether the research studies that your doctor looked at included people like you. Studies often look at people who are young and physically fit.
• You also need to think about what is important to you. If what matters most is that your father died during surgery and you've always been afraid of it, then maybe you should choose to have treatment with aspirin.

It can be difficult to think about all the different things you need to in order to make a decision about treatment. But it is the only way to figure out which treatment is best for you.Return to: How to make the best treatment decisions.