SIDEBAR: Difference between Efficacy and Effectiveness

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One of the reasons large population-based studies are important is based on the “difference between efficacy—does a treatment work in a highly controlled setting of a phase III randomized clinical trial—and effectiveness—does a treatment work in general practice,” according to Benjamin D. Smith, MD. Dr. Smith is corresponding author of a retrospective population-based study of more than 92,000 older women with invasive breast cancer treated with lumpectomy followed by either whole-breast irradiation or brachytherapy. “It is important to understand the effectiveness of a treatment approach in addition to its efficacy,” he said.

Dr. Smith noted that the study also adds to a considerable volume of previous work looking at large population-based data sets with women similar to those in the study cohort, treated with either lumpectomy alone or lumpectomy plus conventional whole-breast radiation therapy. “We found previously that women who receive conventional whole-breast irradiation have about a threefold reduction in their risk of subsequent mastectomy, suggesting that whole-breast irradiation is an effective treatment. Indeed, it is effective when used widely in the community setting,” he said. ■

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In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field.

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SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...




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