I agree with Benjamin. Too many continue to use EBM (or EBHC)
inappropriately - particularly to suggest that EB is based narrowly on
RCTs (or their synthesis) or EB is the application of research data
without explaining the integration of patient’s values or clinician’s
skills/experience. Defining EB is critically important in order to
evaluate the paper.
Ian
> 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 :
> 13101 Bruce B. Downs Boulevard,
> CMS3057
> Tampa, FL 33612
>
>
> -----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]
>
--
Ian Needleman BDS MSc PhD MRDRCS(Eng) FDSRCS(Eng) FHEA
Professor of Restorative Dentistry and Evidence-Based Healthcare
Honorary Consultant and Specialist in Periodontology
Director, International Centre for Evidence-Based Oral Health (ICEBOH)
Unit of Periodontology
Division of Restorative Dental Sciences
UCL Eastman Dental Institute
256 Gray's Inn Road
LONDON WC1X 8LD
UK
Telephone & Fax: + 44 (0) 20 7915 2340
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