The problem of choosing a medicine for the treatment of diseases arose practically from the beginning of the development of medicine as a science. When mankind discovered that a number of chemical and biological substances can affect the human body, established the dependence of dosage and effect, the question arose - and how to correctly apply medicines so as not to harm and get the maximum benefit.

Until the middle of the twentieth century, the question was solved relatively simply: doctors and scientists proceeded from the results of empirical (trial) treatment and the set experiments on animals. Many experts independently experimented with various medicinal substances, tried to apply them under own schemes of treatment, leaned on personal experience. In a number of cases there was a recovery or improvement in the condition of a person, which was written off for successfully selected therapy, but most of such attempts to treat, without relying on a solid evidence base, ended for patients, as a rule, deplorable.

The discovery of pathogens of infectious diseases, a detailed study of the main pathological mechanisms in the human body, as well as the achievements of the chemical and pharmaceutical industries radically changed the approaches to treatment. Science, including medical, was so enriched with knowledge and observations that there was a need to separate the truth from false conclusions or erroneous results. The most famous pharmaceutical drama that occurred in the middle of the XX century "thalidomide tragedy" was another reason to form modern evidence-based approaches to drug selection and to tighten requirements for licensed drugs.

In the mid-fifties of the last century, the German pharmaceutical company Chemie Grunenthal launched the thalidomide drug, which was registered as a sedative and hypnotic. After thalidomide came on the market, there was an increase in the number of children born with congenital defects. The situation in some countries took the form of a real epidemic. In total, between 1956 and 1962, according to various estimates, up to 12,000 children with congenital deformities were born in a number of countries around the world, due to the fact that mothers took thalidomide drugs during pregnancy.

? ? How is treatment selected in modern medicine? In his daily practice, the doctor of any specialty is guided not only by his own knowledge and experience, but also relies on national standards and clinical recommendations that are prepared and approved by the Ministry of Health and the leading scientific centers of the country. The task of treatment standards is to offer the specialist a reliably effective therapy of a particular disease, and clinical and local protocols to describe the algorithm of the doctor's activities in specific cases, in the conditions of a medical institution, taking into account his profile, direction and provision.

In simple words - the reference document clearly indicates to the doctor how to diagnose diseases and conduct their therapy in the conditions of a particular medical institution. The basis of such standards are the long-term achievements of domestic medical associations and foreign medical communities from various scientific centers.

Any pharmaceutical product that is included in national standards and treatment recommendations should undergo a special type of clinical trial - a double-blind, placebo-controlled, randomized trial. The essence of it is this. Randomly chosen patients, with their consent, of course, are treated with a new drug, with half of the study participants receiving a placebo-dummy preparation, which by definition can not cause.

expected therapeutic effects. For the purity of the experiment, neither the doctor, nor even the patient, does not know which group they are assigned to. After the experiment, the obtained data are analyzed statistically and, based on the analysis, a conclusion is made about the effectiveness of the drug.

If the results of treatment of the group of patients receiving the drug are not statistically different from the placebo group, the drug is considered ineffective.

The basis of national standards and protocols is the inclusion in the documents of medications that are recognized effective with a proven clinical effect in a large number of patients.

Thus, if a doctor prescribes to you a drug that is part of national standards and clinical protocols, you can be sure that this medicine has passed all the necessary studies and proved its effectiveness.

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