[Lack of evidence of benefit - using the example of low dose rate brachytherapy for the treatment of localised prostate carcinoma].

The appraisal of new diagnostics or therapies performed by the Federal Joint Committee in Germany often reveals a dramatic lack of evidence of the benefit of such medical treatments. For example, the evaluation of low dose rate brachytherapy used to treat men with local prostate cancer demonstrates that controlled trials still need to be conducted to ensure evidence-based patient care. In Germany, legal incentives are missing to regularly assess the benefits of medical devices and operative techniques.

Pharmacogenetics, adverse drug reactions and public health.

Adverse drug reactions (ADRs) are a major public health problem. Pharmacogenetic testing prior to drug treatment is supposed to considerably alleviate this problem. The state of pharmacogenetic development was assessed by a systematic literature review, supplemented by expert interviews.

Individualized pharmacogenetic therapy: a critical analysis.

Objective: Individualized, or personalized, therapy is highlighted as the declared goal of pharmacogenetics. In this paper, the content and significance of the individualization concept are analyzed.

Method: Our analysis is based on a systematic reading of the current literature pertinent to pharmacogenetics.

Prospects and limits of pharmacogenetics: the thiopurine methyl transferase (TPMT) experience.

Thiopurine drug metabolism is a quintessential case of pharmacogenetics. A wealth of experimental and clinical data on polymorphisms in the thiopurine metabolizing enzyme thiopurine methyl transferase (TPMT) has been generated in the past decade. Pharmacogenetic testing prior to thiopurine treatment is already being practiced to some extent in the clinical context, and it is likely that it will be among the first pharmacogenetic tests applied on a regular basis.