Thrombolytic Agents: The Science of the Art of Choosing the Better Treatment
Authors: Michael E. Farkouh
Journal: Annals of Internal Medicine (1994)

Editorials15 May 1994Thrombolytic Agents: The Science of the Art of Choosing the Better TreatmentMichael E. Farkouh, MD, Jeff D. Lang, MD, and David L. Sackett, MD, MScMichael E. Farkouh, MDDepartments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada., Jeff D. Lang, MDDepartments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada., and David L. Sackett, MD, MScDepartments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-10-199405150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The current dispute about whether the thrombolytic agent of choice for patients with suspected heart attacks should be tissue plasminogen activator (tPA) or streptokinase is succulent. It invokes arguments across the spectrum of health research, from bench to bedside to cost–benefit. Its combatants (and many of their defenders and detractors) are informed, articulate, and proud. The financial stakes are colossal. Reputations and fortunes are on the line. There is enough science and show-biz for every interest and taste. Somewhere, William Osler and H. L. Mencken are exchanging winks.But how ought a clinician decide which of these two treatments, each ...References1. The Gusto Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993:329; 673-82. Google Scholar2. Laupacis A, Sackett DL, Roberts RS. An assessment of clinically useful measures of the consequences of treatment. N Engl J Med. 1988; 318:1728-33. Google Scholar Author, Article, and Disclosure InformationAffiliations: Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.Corresponding Author: David L. Sackett, MD, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Level 5, Headington, Oxford OX3 9DU, United Kingdom. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCost-effectiveness analysis of fidaxomicin versus vancomycin in Clostridium difficile infectionCost-Effectiveness of Thrombolytics: A Simplified ModelStroke thrombolysis: we need new data, not more reviewsThe Costs and Benefits of Community Thrombolysis for Acute Myocardial InfarctionDo potential patients prefer tissue plasminogen activator (TPA) over streptokinase (SK)?Selection of thrombolytic therapy for individual patients: Development of a clinical modelCQI: Improving the time to thrombolytic therapy for patients with acute myocardial infarction in the emergency departmentLa Diffe´renceNumber needed to treat is a simple measure of treatment efficacy for cliniciansInfluences on the Quality of Published Drug StudiesThrombolytic TherapyAcute Myocardial Infarction Treatments in 58 Italian Hospitals: A Drug Utilization SurveyThe demise of the randomized controlled trialCLINICAL PRACTICEMedical Therapy of Acute Myocardial Infarction: Part I. Role of Thrombolytic and Antithrombotic TherapyDoes It Work or Not? 15 May 1994Volume 120, Issue 10Page: 886-888KeywordsCoronary arteriesDrugsHemorrhagic strokeInfarctionMortalityMyocardial infarctionNumber needed to treatStenosisSurgeryTissue plasminogen activator Issue Published: 15 May 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...