RT Journal
A1 Prasad V, Vandross A
T1 RAise the bar even higher for primary prevention interventions—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD September 24
VO 172
IS 17
SP 1352
OP 1353
DO 10.1001/archinternmed.2012.3963
UL http://dx.doi.org/10.1001/archinternmed.2012.3963
AB 
In our article on cardiovascular primary prevention,1 we argue that the bar must be raised. A net clinical benefit should be demonstrated before novel agents are introduced into practice. We use overall mortality as a benchmark for this benefit. Wright and colleagues extend our claim, noting that morbidity must be taken into account. In principle, we agree with their comments. A drug that improves survival, but significantly worsens quality of life, would not constitute a net clinical benefit.