Lane Daniel McNeel
Curr Opin Investig Drugs. 2010 Sep;11(9):987-8.
Comparative effectiveness studies of medications or, more appropriately, studies comparing the safety and efficacy of drugs have been conducted for decades, particularly for cancer chemotherapy. Research oncologists can stratify individuals participating in studies using prognostic criteria based on tissue diagnosis and disease staging. Conversely, research cardiologists, in particular those evaluating drugs for atherosclerotic vascular disease, have had to stratify individuals using criteria based on the risk of having a vascular event (ie, coronary heart disease risk). During the past 20 years, new imaging techniques, such as coronary calcium scoring, that are able to screen asymptomatic populations for atherosclerosis have been developed. In the future, studies comparing drugs for cardiovascular disease should be based on the presence of disease, such as atherosclerosis, rather than on the risk of a vascular event.
药物的比较有效性研究，或者更确切地说，比较药物安全性和有效性的研究已经开展了数十年，尤其是在癌症化疗方面。肿瘤学研究人员可以根据组织诊断和疾病分期的预后标准，对参与研究的个体进行分层。相反，心脏病学研究人员，特别是那些评估用于治疗动脉粥样硬化性血管疾病药物的人员，不得不根据发生血管事件的风险（即冠心病风险）标准对个体进行分层。在过去20年中，已经开发出了新的成像技术，如冠状动脉钙化评分，能够对无症状人群进行动脉粥样硬化筛查。未来，比较心血管疾病药物的研究应基于疾病的存在，如动脉粥样硬化，而不是基于血管事件的风险。
