english.prescrire.org > Spotlight > Archives : 2014 > Harm-benefit balance: a fundamental concept that needs to be grasped

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Harm-benefit balance: a fundamental concept that needs to be grasped

The choice of a medical, diagnostic, therapeutic or preventive intervention is determined by its harm-benefit balance. This concept needs to be fully grasped in order to obtain the maximum benefit that medicine and pharmaceuticals can provide.

Do the expected benefits from a drug or other medical intervention outweigh its potential adverse effects or drawbacks? Each day, healthcare professionals and patients ask themselves this simple question, whose consequences are sometimes vital.

This is also the question that drives the day-to-day work of Prescrire, which reviews all the information available to help healthcare professionals to make the best choices from the various options available, and to share their decisions and uncertainties with their patients.

Evaluation of the harm-benefit balance takes as its starting point a population. Evaluation of the benefits takes into account several factors: the strength of evidence from clinical trials, the extent and probability of the benefits in these trials, and the characteristics of the patients taking part. Evaluation of the harm includes the identification of adverse effects and the compiling of an array of arguments to determine the potential adverse effects. Account must also be taken of particular situations (age, pregnancy, medical history, concurrent medication, etc.) and the risk of error.

On the individual patient level, the harm-benefit balance depends on each patient’s characteristics, their goals and their values; it also depends on the healthcare professionals and on the medico-social environment. It is in patients’ best interests for decisions taken to be reviewed regularly in the light of advances in knowledge and changes in the patient’s particular situation.

To help patients and healthcare professionals obtain the maximum benefit that medicine and pharmaceuticals can provide, the full text of Prescrire’s analysis of this issue is being made freely available via the link below, and all media are authorised to reproduce it, on simple request to presse@prescrire.org.

©Prescrire 1 November 2014

"Determining the harm-benefit balance of an intervention: for each patient" Prescrire Int 2014; 23 (154): 274-277. (Pdf, free).

Download the full review.
Pdf, free

See also:

Evaluation of treatment
benefits: clinical endpoints
relevant to patients
Prescrire Int 2008:
17 (98): 260.
Pdf, free

Evaluation of treatment
risks: taking clinical data,
pharmacology and patient
characteristics into account
Prescrire Int 2010:
19 (105): 44-46
Pdf, free

Treatment goals:discuss
them with the patient
Prescrie Int 2012:
21 (132):276-278.
Pdf, subscribers only