Matching the standards of clinical trial evidence with application in practice

A high standard of proof of efficacy and safety is required in clinical trials. This standard requires careful translation into practice, combining an evidence-based approach with clinical experience and judgment to maximise patient benefits and minimise harms. The tendency to extend application of new treatments to patient groups other than those for whom reliable data exist should be avoided. Equally, extrapolation of the data to agents of the same class untested for particular indications should not occur. If the considerable potential benefits of modern cardiovascular therapeutics are to be maximised and harms avoided, clinicians should observe these principles carefully as new treatments become accessible and are applied.