As this is the second major issue coming from WHO (the first was on levels
of BP for adequate control following the HOT study) perhaps we should offer
our help. Clearly the organisation faces a massive task in assembling
information and producing reports - we should as individuals and units
offer our services generally before the reports are written so that these
sorts of issues can be addressed before the msitakes are made.
how we contact them and make them aware of these offers is the next
problem.
martin
Dr Martin Dawes
Director
NHS R&D Centre for Evidence Based Medicine
University of Oxford
John Radcliffe Hospital
Oxford OX3 9DU
-----Original Message-----
From: Gibis, Bernhard [SMTP:[log in to unmask]]
Sent: 02 December 1999 16:38
To: [log in to unmask]
Subject: Bone density measurement
Dear Colleagues:
We are currently evaluating bone density measurement (BDM) and have reached
the same conclusions as all other health technology assessment reports and
evidence-based reviews, ie. that BDM is not suitable for secondary
prevention and a general screening per BDM measurement cannot be
recommended
at this time.
We were surprised, therefore, to read a press release of the World Health
Organization (WHO), in October 99, stating that: "Early detection is the
key. By measuring bone mineral density (BMD) it is easy to identify those
at
risk and to suggest preventive course of action."
http://www.who.int/inf-pr-1999/en/pr99-58.html
Where?s the evidence? We called Dr.Khaltaev (who is responsible for the
osteoporosis programme) at WHO, in Geneva, and numerous experts in the
field
were named but no hard evidence was given.
We are now going to send WHO a list of HTA reports and systematic reviews,
but what else can we do? I think in times of evidence-based medicine an
organization such as WHO should not initiate world wide programs which
appear to rely only on expert advice.
Do you agree? Any comments, ideas as to how we might encourage WHO to
adopt
evidence-based decision making?
Bernhard Gibis
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Bernhard Gibis, MD (Ob/Gyn), M.P.H.
NASHIP
National Association of Statutory Health Insurance Physicians
Department of Health Technology Assessment
Herbert Lewin Street 3
Germany - 50935 Cologne
Tel.: +49 221 4005 328 (Secr.)
+49 221 4005 332 (direct)
Fax.:+49 221 4005 7332
email.: [log in to unmask]
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