The actual evolution once the patient has been taking the treatment should correspond as closely as possible to the previously made prediction. In statistical terms, the clinician should predict much of the variance of drug response; and should
achieve a high predictive accuracy (defined by the sum of the correct predictions divided by the total Inhibitors,research,lifescience,medical number of predictions). In colloquial terms, the goal is to know with little doubt that one is “betting a horse that will be the winner―or among the winners.” The prediction of outcome is a prerequisite to personalized therapy, Inhibitors,research,lifescience,medical ie, a treatment chosen on the basis of the patient characteristics. Several steps precede this choice of therapy. A diseased state has to be recognized as such by both the patient and the physician; a diagnosis should be made in accordance with the profile of complaints and symptoms, as well as with classification criteria; the severity of the disorder should be correctly assessed; and a prognosis should be made. Misunderstanding, ignorance, or error can occur at each of these steps, leading to a decreased accuracy of the predictions Inhibitors,research,lifescience,medical of outcome, as well
as to a decrease in the usefulness of therapy. These issues are the domains of studies on the rate of recognition of diagnoses, the concordance (or Inhibitors,research,lifescience,medical discordance) between structured interviews and therapists’ evaluation, the usefulness of asking for a second opinion, interobserver reliability, and the test/retest reliability in scales scoring. In order to tailor therapy to the Inhibitors,research,lifescience,medical individual, the clinician has information that can be classified into three different sets. The first set consists
of clinical trials findings where patients were included in trials according to their clinical characteristics and then randomized into treatment subgroups on the basis of demographic or social data and scores on clinical scales. Oxalosuccinic acid Results from clinical trials are average results, giving an overall probability of favorable response in a predefined patient population. Controlled clinical trials are the basis for evidence-based medicine, a method that is selleck chemical progressively being applied in psychiatry. The second set of information consists of local or national opinions, or habits about the prescription of medication. Clinical guidelines are an illustration of such information; they combine information from evidence-based medicine and expert consensus statements based on clinical experience.