Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Evidence-Based Practice
Lecture:Phrasing the clinical question
Harm and prognosis
Slide content:Examples of Questions to Answer about Harm Do silicone breast implants cause autoimmune diseases, such as lupus? (Gabriel et al., 1994; Vase, 2013) Women with silicone breast implants developed connective tissue diseases and arthritis but at no higher rate than those without them Do anti-obesity drugs (e.g., fenfluramine and phentermine, also known as fen- phen ) cause heart valve abnormalities? ( Gardin et al., 2000; Andrejak , 2013) Those who used these drugs developed certain heart valve abnormalities at a higher rate than those who did not 5
Slide notes:5 Here are some examples of questions that have come up in the news media about whether things cause harm. Back in the mid and early 1990s, there was the issue of whether silicone breast implants caused auto-immune diseases such as lupus and rheumatoid arthritis. It was definitely true that some women who had implants developed these diseases, which are commonly called connective tissue diseases ; but they didnt develop them at a higher rate than those who had no breast implants. So, silicone breast implants dont appear to cause these auto-immune diseases despite the many lawyers who believe to the contrary. Another question that came up in the 1990s was whether a number of anti-obesity drugs on the market at the time, such as fenfluramine [fen- floo r -uh- meen ] and phentermine [ fen - ter - meen ] (also known as fen- phen ), caused problems such as heart valve abnormalities. It turned out that those who used the drugs actually did develop certain heart abnormalities at a higher rate than those who didnt use the drugs.