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A constant theme in drug development has been the need to personalise medicine and that the ‘one-size fits all’ mentality needs to be replaced by one that recognises differences in from patient to patient of reaction to treatment as being fundamental. Of course, progress in medicine has always been accompanied by advances in diagnosis and the recognition that what was once regarded as a single diseases should now be regarded as many. Nevertheless, I shall argue that the scope for personalised medicine has been fundamentally misunderstood and is currently over exaggerated. The fault lies with naïve and incorrect interpretation of results from clinical trials. I shall present some simple mainly graphical methods for understanding the problem and conclude that, paradoxically, we may make more progress by realising that less progress is possible.
