Use and abuse of clinical trials. Is the dose used the dose tested?

Clinical trial results are not readily adopted into everyday clinical practice. Despite the publication of numerous clinical studies, many findings still continue to be ignored, misunderstood or remain unknown by physicians. In clinical trials, drug dosing and timing are carefully planned and rigorously applied. In clinical practice, however, physicians rarely use the doses that are reported to be associated with benefit. In general, physicians measure physiological variables and titrate drug doses to attain a therapeutic effect. Most physicians begin with a low dose in the belief that the desired effect may be achieved without any toxic effects. However, underdosing may deny the chance of benefit.