Abstract
TYPING THE WORD “aprotinin” into an Internet search engine returned a screen displaying 20 links for further information, 10 of which were legal firms wishing to represent the author in a lawsuit against Bayer Pharmaceuticals for poor outcome from recent cardiac surgery. Searching the phrase “aprotinin lawyer” returned a total of 14,400 links. Fortunately, the tightness in the author’s chest was not from coronary artery disease but rather the dyspepsia that comes from observing a medicolegal system that allows allegations to be leveled at a therapy based on retrospective association studies that conflict with previous results from multiple prospective, randomized, double-blind, placebo-controlled trials. Although the author is a strong advocate of weighing risk and benefit for any therapy administered to a patient, using weak but highly publicized evidence to demonize a treatment seems unwise and could deprive patients of a potentially helpful agent. Such controversy does, however, impel clinicians to take a close look at the evidence behind their practice.
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