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As a publication that regularly reviews new medicines, DTB recognises the challenge facing prescribers as they attempt to balance the benefits and harms of drug treatment. Assessing whether a medicine (new or old) will result in a net benefit to a patient requires careful interpretation of the evidence on efficacy and adverse effects.1,2 In 1990, we noted that a realistic appraisal of a drug’s safety “requires knowledge of the frequency and seriousness of the drug’s unwanted effects and interactions, including their predictability and reversibility, whether they are related to dosage and duration of treatment, risk factors, the precautions needed to prevent or minimise them and how much effort these entail”.3 With the …