Nexium Online

posted on 26 Aug 2012 01:31 by nexiumonlineu
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12 88 From Table 4 it would appear that the patients were somewhat more opti- mistic than the physicians regarding improvement in general and regarding the benefits of the trial therapy ; and a similar observation was made in an anti- malarial trial. It appears, also, however, that the patients were more i)e.!simi.stic* regarding deterioration that they were more ready to report change, in one or other Nexium Online direction, than the physicians. (A more detailed examination of such contrasts is being made in the data from the Seven-day Variability Study.) TABLE 4. OBSERVERS' AND PATIENTS' ASSESSMENTS (Numbers of Nexium Online patients: Placebo, 223; aspirin, 218] Assessors and therapies Changes from initial to final examination (percent of pts.) Improved About the same Worse Observers: Placebo. Aspirin. Patients: Placebo. Aspirin. COMPETITIVE PROBLEMS IN THE DRUG INDUSTRY 3359 FURTHEai ANALYSES Many questions, in addition to those discussed in this report, have l)een applied to the data from this trial, such as the question Nexium Online of the interrelati()nshii)s of cumulative eflei-t, re<"eucy of last dose and amounts of aspirin consiunetl an attempt to see whether the trial could give any clue to an 'optinnun" aspirin regimen. However, it seemcnl desirable at this stage to pres<'nt an overall view. as an invitation to readers to submit questions and suggestions that would help in the preparation of the more detailed report. PARTICIPATING CENTERS Lack of space prevents listing the 46 observers and about 16 study-secretaries who contributed to this trial. (Study secretaries did not contribute patient assess- ments as some of them did in the Seven-day Variability Study.) The 11 partici- pating centers were: Southwestern Medical Sch(K)l, Dallas; State University of New York. Downstate Medical Center, Brooklyn; University of Illinois. Chicago: University of California and V.A. Hospital, Los Angeles ; Massachusetts General Hospital. Boston ; Jackson Memorial Hospital. Miami; Rackham Arthritis Re- search Unit. University of Michigan. Ann Arbor; N.I.A.M.D. and Georgetown University Medical (Vnter. Bethesda and Washington. D.C. ; Presbyterian Hos- pital. New York ; I'niversity of California. San Francisco ; University of Tennessee, Memphis. Nexium Online ACKNOWLEDGMENTS The Cooperating Clinics' program is Nexium Online supported by Grant AM-03252 from the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health. U.S. Public Health Service. The Coordinating Center is indebted to Mrs. Nexium Online M. O. Blake, Mr. P. C. Miller and Miss A. C. Powell for assistance in the analyses ; and to the Merck Company for its generous and painstaking coopera- tion in the provision of drug and placebo. Medical Statistics Unit, Boom 1106, 112 East 19th Street, New York. X.Y. Prepared for the A.R.A. Cooperating Clinics Committee by Donald Mainland. M.D., Ch.B., D.Sc, and Marion I. Sutcliffe, B.S., and revised by the Publications Subcommittee. Senator Nelson. Please go ahead, Doctor. Dr. Lawtiasox. We doubt whether even the authors of this tentative, exploratory, and hopeful experimental design, with all of the complex statistical loose ends that remain to be tied up, would hold it up to the world as a finished and refined tool of biostatistics and control. Nexium Online Let me make it clear that we at Merck are in no way opposed to the intense desire of experts in rheumatology to take steps forward in clinical desig;n. However, we do not accept the validity of the co- operating clinics study presented to this committee last week as a measure of the value of indomethacin in medical practice. We do not believe a wliollv satisfactory double-blind study for demonstrating the effect of a \lrug in tre;iting rheumatoid arthritis has yet been designed. From what we know today, no drugs used in rheumatoid arthritis Nexium Online get at the cause of the disease, nor do they appear to halt its ultimate progression. Thus we are talking about drugs which will only give relief of symptoms. Much of this can be determined only by the patient and his physician. At this state of our knowledge there are no really good objective measurements or tests. Those we have, at best, are very crude. The rlieumatoid patient manifests no objective labora- tory parameters, such as tiie l)l()od sugar of the diabetic, which the physician can point to and which enai)le him to know if the patient is improving. 3360 COMPETITIVE PROBLEMS IN THE DRUG INDUSTRY As you know, aspirin has been the backbone of drug therapy in the rheumatoid patient for many years. Therefore it is natural that in- domethacin would be compared with aspirin in rheumatoid arthritis, just as any new drug would be compared to an accepted standard therapy of the day. Aspirin is generally accepted by both the medical and lay public as safe. However, there is a great deal of history with
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