I found this statement peculiar:
"We are proud to note that none of the papers in this special edition offer a definition of EBM." No doubt, it is not easy to define a concept of evidence (and by extension EBM), but without attempting to do so, we will just continue to see highjacking the concept of EBM...
Benjamin Djulbegovic, MD, PhD
Professor of Medicine and Oncology
Co-Director of Clinical Translation Science Institute
Director of Center for Evidence-based Medicine and Health Outcomes Research
Mailing Address:
USF Health Clinical Research
12901 Bruce B. Downs Boulevard, MDC02
Tampa, FL 33612
Phone # 813-396-9178
Fax # 813-974-5411
e-mail: [log in to unmask]
______________________
Campus Address: MDC02
Office Address :
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-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Frances Gardner
Sent: Sunday, January 04, 2009 4:42 PM
To: [log in to unmask]
Subject: Re: Fw: Special Issue:Evidence in Evidence-Based Medicine Fw: Social Epistemology - informaworld
Hum. There are some marvellous phrases ["Efficacy as a Rhetorically Mobile
Boundary Object" "RCT Reports as Idealising Genres"] in the paper by
Derkatch, and very large straw men used to explain why we cant possibly have
decent evidence to test whether complementary therapies (CAM) work eg on p50
see below - all treatments must be the same for all patients in an RCT, and
RCTs cant be done because double blinding cant be done. The first two papers I
found more interesting and perhaps better informede.
Frances
Dr Frances Gardner, Professor of Child and Family Psychology
Department of Social Policy & Social Work, Oxford University
32 Wellington Square, Oxford OX1 2ER, UK
tel:44-1865-270334 [log in to unmask]
From page 50:
Studies of CAM pose significant methodological questions because the practices
do not generally translate well into the "gold standard" RCT. Randomisation and
standardisation are foreign, and often incommensurate, concepts in CAM
practices, which, in contrast to biomedicine, tend to view patients as
fundamentally unique, so two people with the same ailment might be treated
altogether differently, depending on their unique constellation of symptoms
and/or personal characteristics (Barry 2006, 2647; Degele 2005, 118). Corollary
to this emphasis on uniqueness is that treatments can be difficult to
standardise in experimental settings: while biomedical treatment is largely
symptomatic in the sense that a person may be treated separately for different
conditions (even by separate specialists), many CAM practitioners aim to
address all symptoms together.6
Controlling and blinding studies of manual practices such as acupuncture or
chiropractic are also difficult because they involve unmistakable physical
actions that are difficult to simulate (e.g. piercing the skin and moving the
spine with an often audible
popping sound). In a practice such as acupuncture, there is no available
control that is both realistic and definitely inert (a la sugar pill), and
practitioners usually cannot be
blinded. These methodological problems leave researchers to puzzle out how such
studies ought to be conducted, interpreted, and incorporated into practice
because the practices do not fit easily with conventional scientific procedures
or genres
In message <[log in to unmask]>
Alejandro Piscoya <[log in to unmask]> writes:
> Got access "trough the grapevine". I feel intimidated by all the phylosophic
> terms involved in these articles so I am waiting for your comment in order
> to try to understand some of what is written here...
>
> Alejandro
>
>
>
> On Sun, Jan 4, 2009 at 2:47 PM, Dan Mayer <[log in to unmask]> wrote:
>
> > Hi everyone,
> >
> > This looks suspiciously post modern. I'd love to read it and be able to
> > comment. However, I can't get on any of the articles. Anyone have access?
> > It costs $197 to purchase the issue and about $25 per article.
> >
> > Dan
> >
> > PS: Happy New Year
> >
> >
> >
> > ****************************************************************************
> > Dan Mayer, MD
> > Professor of Emergency Medicine
> > Albany Medical College
> > 47 New Scotland Ave.
> > Albany, NY, 12208
> > Ph; 518-262-6180
> > FAX; 518-262-5029
> > E-mail; [log in to unmask]
> >
--
Dr Frances Gardner, Professor of Child and Family Psychology
Department of Social Policy & Social Work, Oxford University
32 Wellington Square, Oxford OX1 2ER, UK
tel:44-1865-270334 [log in to unmask]
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