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Invited Commentary| Volume 61, ISSUE 3, P205-206, March 2008

Pharmacoepidemiology and “in silico” drug evaluation: is there common ground?

  • Til Stürmer
    Correspondence
    Corresponding author. Tel.: +1-617-278-0627; fax: +1-617-232-8602.
    Affiliations
    Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, USA
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  • Kenneth J. Rothman
    Affiliations
    Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, USA

    RTI Health Solutions, RTI International, Research Triangle Park, NC, USA
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  • Jerry Avorn
    Affiliations
    Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, USA
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      Shortcomings of randomized trials have long been recognized by medical researchers [
      • Avorn J.
      Powerful medicines: the benefits, risks, and costs of prescription drugs.
      ,

      Strom BL, ed. Pharmacoepidemiology. 4th ed. West Sussex: Wiley & Sons; 2005.

      ]. These shortcomings include a reduced range of risk factors for the outcome among patients enrolled in preapproval trials. The reduced range enhances the validity of the trials, but the patient populations are highly selected compared with the broad range of risk factors represented among patients who are eventually treated with the drug. This restriction may reduce the generalizability of the findings from those studied to those with different baseline risks.
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