Second pass at: When your prescriber and the evidence disagree

The failure mode on prescriber is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.

I have no financial interest in anything named in this thread and I want to say so before I comment on prescriber, because it is the sort of subject where it matters.

Small correction to my own earlier position on prescriber. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.

The arithmetic in post #23 is right; the assumption feeding it is the part to check.

If you have been doing something the prescriber does not know about, saying so is more useful than not. Clinicians here consistently say they would rather know.

Not disagreeing with anyone above, just adding the bit I keep having to look up.

No disagreement from me. Posting only so the question does not look ignored.

Two things can be true about prescriber at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.

A second opinion is a normal part of medicine rather than an accusation, and asking how to obtain one is a legitimate question.

Written from notes rather than memory, which is why the numbers are specific.

Adding the measurement that post #52 says would settle it.

Where the prescriber reasoning breaks down for me is the step from the group result to the individual case. That step is almost never argued for.