Cardiovascular Disease Prevention at a Crossroads:: Precision Medicine or Polypill?

Michael J. Joyner; Nigel Paneth

doi:10.1001/jama.2019.19026

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November 25, 2019

Cardiovascular Disease Prevention at a Crossroads:Precision Medicine or Polypill?

Michael J. Joyner, MD¹; Nigel Paneth, MD, MPH^2,3

Author Affiliations Article Information

¹Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
²Departments of Epidemiology and Biostatistics, Michigan State University, College of Human Medicine, East Lansing
³Departments of Pediatrics and Human Development, Michigan State University, College of Human Medicine, East Lansing

JAMA. 2019;322(23):2281-2282. doi:10.1001/jama.2019.19026

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November 26, 2019

Controlled Trial Should Have a True 'Usual Care' Arm

Oliver Frank, MBBS PhD | Oakden Medical Centre and University of Adelaide, South Australia

"The proposed trial should have 3 intervention groups: a polypill group, a precision medicine group, and a conventional risk factor modification group."

In this proposed trial, as well as in other trials that have an arm in which placebo treatments are administered, there would be a benefit to including a true 'usual care' arm. This is because it is becoming evident that even the offering and use of a placebo medicine or other treatment can and often does have some effect. The need to obtain consent from participants might make it difficult or impossible to have a true 'usual care' arm, but the exercise could still be worth doing.

CONFLICT OF INTEREST: None Reported

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