Even if a trial yields a result which is clinically meaningful, it is important to take the results of that study one step further by asking yourself, "Is the size of that benefit likely to be helpful for my patient?". Many trials report significant differences in treatment responses that might sound impressive at face value, yet when one considers the magnitude of such benefits, they are less exciting. Even when the study benefits are of large magnitude, they may still not be enough. Consider a patient with a facial port wine stain who is treated by pulsed tunable dye laser, and who achieves a 70% reduction in total surface area involved. We might be impressed by such a magnitude of gain, but if the patient is still unhappy because he or she feels that the stigma associated with the residual lesion is just as disabling, or that the odd pattern of circular pale holes left by the laser within the lesion draws even more attention to it, then this is a treatment failure.
Thus, it is crucial to consider not only if a treatment is effective in a published report, but to follow with the additional question of how effective. It follows that an important part of the discussion with the patient is to agree on what is possible or not possible in terms of realistic treatment objectives.
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