TY  - JOUR
T1  - Antihypertensive therapy in the elderly: Evidence-based guidelines and reality
AU  - Gambassi G, Lapane K, Hume AL, Carbonin P, Bernabei R
Y1  - 1999/07/26
N1  - 
JO  - Archives of Internal Medicine
SP  - 1622
EP  - 1622
VL  - 159
IS  - 14
N2  - 
These limits are not newly recognized. Some 38 years ago, questions arose regarding the direct application of results coming from trials as a successful strategy to advance the overall health of the individual or the population.1 In fact, while it has been highlighted that the relative benefit of interventions is constant across defined subgroups within trial populations,2 the heterogeneity of effect within the general population may well be substantial. The problem is that randomized trials are by design not able to address this heterogeneity. Trials examine primarily medical interventions; randomization (if successful) permits comparisons of interventions not confounded by the "individuality" of patients.3 Here is the paradox of the trial: it is the best way to assess whether an intervention works but is arguably the worst way to evaluate who will benefit from it. This contradiction leaves a gap in the evidence available for clinicians.

SN  - 0003-9926
M3  - doi: 
UR  - http://dx.doi.org/
ER  -