Statistics in Medicine: merit and mith cogitation of a clinician
Keywords:
statisticsAbstract
Biological sciences are not of an exact nature. Medicine is not properly a science, but a scientifically founded profession wich deals with individual cases of undefinable variety. To mathematize Medicine is attempting but faces great limitations. Statistics, the branch of mathematics more closely linked to medical activities, is very useful to define trends. Nevertheless, there is no guarantee that statistical antecipations will in fact happen, in a individual case.
Additionally to this limitation of intrinsic nature, one must be aware of formal errors, abusive interpretations, difficulties in reading results, differences of conclusions in dependence of methods, and many other problems. Clinical decision must consider statistical data, among several other sources of information. However, the global sense of the doctor will never be replaced by the myth of an abstract and unexpressive list of figures. A diagnostic procedure, a therapeutic approach, the disclosure of the prognosis are always personal choices. The physician makes his option having in mind the complex problematic of an individual patient, wich is by no means possible to simplify in a formula or an equation.
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References
Me Dermott W. Medicine in modem society. ln Beeson P, Me Dermott W e Wyngaarden J, eds. Ceei! Textbook of Medicine. Philadelphia, WB Saunders Co., 1979:8.
Robertson JIS e Bali SG. Hypertension for the clinician. London, WB Saunders Co., 1994: 157.
Berglund G, Andersson O e Wilhelmsen L. Prevalence of primary and secondary hypertension. BMJ 1976; 2: 554-6.
Rudnik KV, Sackett DL, Hirst S e Holmes C. Hypertension in a family practice. Can Med Asso 1977; 117:492-497.
Sigurdsson~JA, Bengtsson C, Tibblin E, Wojciehowski J. Prevalence of secondary hypertension in a population sample of swedish women. Eur Heart J 1977; 4:424-431.
Lewin A, Blaufox D, Castle H, Entvisle G e Langford H. Apparent prevalence of curable hypertension in the Hypertension Detection and Follow-up Program. Arch Intern Med, 1985; 145: 424-427.
Gifford Jr. RW. Evaluation of the hypertensive patient with em phasis in detecting curable causes. Milbank Mem Fund Q 1969; 47: 170-175.
Ferguson RK. Cost and yield of the hypertensive evaluation. Ann. Intern Med 1975; 82:761-765.
Sinclair AM, Isles CG, Brown I, Cameron H, Murray GD, Robert son JWK. Secondary hypertension in a blood pressure clinic. Arch Intern Med 1987; 147: 1289-1293.
Kaplan NM. Hypertension in the individual patient. ln Kaplan NM, ed. Clinicai Hypertension. Baltimore, Williams and Wilkins, 1990: 17.
Gordon RD, Klemm S, Stowasser M, et al. How common is primary aldosteronism? Is it the most frequent cause of curable hypertension ' Sixth European Meeting on Hypertension, Milan 1993; Abstract no.278.
Andersen GS, Toftdahl DB, Lund OJ, et ai. Primary aldostero nism. J Hum Hypertens 1988; 2: 187.
Prisant LM, Houghton JL, Bottini PB, Carr AA. Cardiopatia hipertensiva. Postgraduate Med (versão port.) 1995; 3 (5): 19.
NeatonJD, GrimmJr. RH, Primas RJ, et al., forThe Treatment of Mild Hypertension Research Group. Treatment of Mild Hyper tension Study (TOMHS), final results. JAMA l 993; 270:713- 724.
Dahlof B, Pennert K e Hansson L. Reversai of left ventricular hypertrophy in hypertensive patients, a metaanalysis of 109 treatment studies. Am J Hypert 1992; 5:95-110.
Joint National Committee on Detection, Evaluation and Treat ment of High Blood Pressure. The fifth report of the JNC. Arch Intern Med 1993; 153: 154-83.
Psaty BM, Heckbert SR, Koepsell TO, et al. The risk of myocardi al infarction associated with antihypertensive drug therapies.
JAMA 1995; 274:620-625.
Lenfant C. The calcium channel blocker scare, lessons for the future. Circulation 1995; 91: 2855-2856.
BuringJE, Glynn RJ e Hennekens CH. Calcium channel blockers and myocardial infarction, a hypothesis formulated but not yet tested. JAMA 1995; 274:654-655.
Saavedra JA. Terapêutica individualizada "versus" terapêutica escalonada na hipertensão arterial. ln Braz - Nogueira J e Nogueira da Costa, eds. Hipertensão Arterial, Clínica, Diagnóstico e Terapêutica. Lisboa, Permanyer Portugal, 1993: 184.
Brenner BM e Lazarus JM. Chronic renal failure. ln Isselbacher K, Braunwald E, Wilson J, et al., eds. Harrison's Principies of Internal Medicine. New York, Me Graw-Hill, Inc, 1994.1274- 1275.
Oliveira-Soares A. Diagnóstico da hipertensão arterial secundá ria. ln Braz-Nogueira J e Nogueira da Costa J, eds. Hipertensão Arterial, Clínica, Diagnóstico e Terapêutica. Lisboa, Permanyer Portugal, 1993: 23.
Peres-Gomes F. Comunicação pessoal e várias referências breves na literatura.
Feinstein AR. Tempest in a P-pot? Hypertension 1985; 7: 313-8.
Oliveira-Soares A. A quantificação do número de doentes e de técnicas no curriculum vitae. Seminários de medicina interna do Serviço de Medicina 2 do Hospital de Santa Maria, 1995 (Palestra não publicada).
Oliveira-Soares A. Ensino e sua avaliação após a licenciatura em medicina. Medicina Interna 1994; 1(2):127-128.
Chalmers J. Personal view: the national consensus conference not always what it seems (editorial). Blood Pressure 1994, 3: 4-6.
Woods KL. Mega-trials and management of acute myocardial infarction. Lancet 1995; 346: 611.
ISIS 4 Collaborative Group. ISIS 4 : a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium in 58,050 patients with suspected acute myocardial infarction. Lancet 1994; 345: 669-685.
Oliveira-Soares A, Nogueira da Costa J., Figueiredo-Lima J, Braz Nogueira J, Henriques AP e Saavedra JA. Análise dos internamentos numa secção hospitalar de medicina interna. O Médico 1979; 93 (1468): 93.
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