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David Healy – Time to abandon evidence based medicine
We have reached a critical juncture. On the one hand we have evidence from company run trials, up to half of which remain unpublished and over 80% of which are ghostwritten, and close to 100% of which the data are unavailable for independent scrutiny. On the other hand we often have evidence of a problem appearing on a drug, that clears when the drug is stopped and reappears when it is restarted.
This kind of evidence until recently was thought to be the strongest causal evidence there was in clinical practice. In over 80% of cases evidence like this turns out retrospectively to have been right. So which is the more dependable when treatments go wrong, the evidence from company trials or the evidence from doctors and patients own eyes?
When they hear Evidence Based Medicine most people think they are hearing Data Based Medicine. It is an irony that trials are used to drown out good observations from individual case studies when such case studies are often the one group of studies in modern medicine where we actually have the data – the person who was injured and their clinical record.
It seems, if only for rhetorical purposes, we need a way to demonstrate how unreasonable it is not to take such reports seriously. If the Church is to survive, we need some Cardinals to take up this cause.
– See more at: http://davidhealy.org/the-church-of-gskology-2/#sthash.9wSQCfHb.dpuf