On 8 Iúil 2009, at 17:40, Maskrey Neal wrote:
> For me this links into where we're going with EBM. I think we're in
> the 3rd age and tip-toeing into the 4th. EBM v1.0 was conceptual.
> EBM v2.0 was and is technical development - searching skills, MA
> stats etc. EBM v3.0 was and is the industrial age - Cochrane
> collaboration, teaching critical appraisal to anyone who shows
> interest etc. And so I'd profer that if we want to make EBM really
> live for people (cf threads on this group on a number of occasions)
> EBM v4.0 needs to be Customer Focussed. The customers are
> clinicians, patients, commissioners and no doubt others. And if we
> want to reach those groups we need to think about they as humans use
> EBM outputs as information and how they use those to make decisions.
> People need to be careful who they talk to and what they (briefly)
> read.
I think that the major dimension of EBM v4.0 is that if there is a
customer, then there is a profit. 4.0 will have to include an
awareness of the effect that pharma is having on the evidence, by
clever trial design, selective publication, falsification of evidence,
the use of publication companies to place their product in the
literature, by direct-to-consumer advertising and so forth.
The old EBM model of reading each paper as though it were an isolated
- or isolable - entity is flawed. We need to move from checklists for
appraising individual papers to an awareness of the global marketplace
in which this evidence is produced and the massive commercial
interests at stake.
Ronan Conroy
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