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. 2009 Nov 25;302(20):2254-6.
doi: 10.1001/jama.2009.1679.

Therapeutic innovations, diminishing returns, and control rate preservation

David M Kent  1 , Thomas A Trikalinos
Affiliations

Therapeutic innovations, diminishing returns, and control rate preservation

David M Kent et al. JAMA. .
No abstract available

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Figures

Figure
Figure. Marginal Benefit and Unit Cost for Successive Rounds of Innovation
Shown are the calculated absolute benefit (B, black line) and associated unit cost (U, number of trial enrollees for each incremental 1% of benefit, red line) for 5 hypothetical therapies tested in sequence, assuming a baseline mortality rate of 8% and a constant relative risk reduction (i.e. efficacy, E) of 25% with each therapy. The appendix shows the derivation of the formulae used to calculate B and U at the i-th generation of treatments based on their initial values (B0 and U0, at generation 0). Note the rate of change of U is sensitive to E. Over 5 generations, U increases more than 6-fold when E is 20%, more than 10-fold when E is 25% (as shown) and more than 25-fold when E is 33%.
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References

    1. Randomised trial of intravenous streptokinase, oral aspirin, both or neither among 17, 187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2(8607):349–360. - PubMed
    1. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators. N Engl J Med. 1993;329(10):673–682. - PubMed
    1. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361(9351):13–20. - PubMed
    1. Nordmann AJ, Bucher H, Hengstler P, Harr T, Young J. Primary stenting versus primary balloon angioplasty for treating acute myocardial infarction. Cochrane Database Syst Rev. 2005;(2):CD005313. - PMC - PubMed
    1. Pasceri V, Patti G, Speciale G, Pristipino C, Richichi G, Di SG. Meta-analysis of clinical trials on use of drug-eluting stents for treatment of acute myocardial infarction. Am Heart J. 2007;153(5):749–754. - PubMed

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