The Evidence Is In

By Malcolm Fleschner

Do you find that physicians have become more skeptical? Have you ever delivered a presentation using a new clinical reprint only to be rebuffed when the doctor learns that your company funded the study? Despite the fact that the trial was randomized, double-blind, placebo controlled and conducted by blindfolded chimps in Vice President Cheney’s underground bunker, the doctor still can’t be convinced, and you walk away upset and discouraged.

So what’s a conscientious drug rep to do? Writing in Pharmaceutical Representative Online, consultant K.C. Warner of Warner Development and former drug rep Margaret Grubb say that reps need to adapt to a new practice paradigm in the medical profession called evidence-based medicine by presenting clinical reprints in a more thorough fashion that closely follows the dictates of evidence-based medicine.

The key, they say, is to consider the perspective of the physician and then present the salient criteria he or she expects. This requires two key skills:

1. The ability to critically evaluate studies based on the following list of factors:

-last observation carried forward
-sufficient follow-up
-blinding, randomization
-number needed to treat
-number needed to harm
-mean measure of central tendency
-statistical significance
-clinical significance
-absolute risk reduction
-standard deviation
-cohort study
-crossover study design
-event rate
-case control study
-cross-sectional study
-intention to treat

2. The ability to present reprints to physicians using these criteria to help the physician apply this knowledge to patient concerns.

Part of what the authors term “evidence-based selling” involves recognizing that no study is perfect because science is not perfect. The rep’s goal, therefore, should be to help physicians understand whether individual studies are germane to their practices and their patients. Translate statistical significance into clinical significance, say Warner and Grubb, and you will become a valued consultant to your customers, rather than just another of the dozens of detail reps who walk in the door every day.