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How evidence-based medicine is failing due to biased trials and selective publication. -just in case/por si acaso -the full paper/el texto íntegro http://onlinelibrary.wiley.com/doi/10.1111/jep.12147/pdf 2014-05-15 9:40 GMT+02:00 Juan Gérvas <[log in to unmask]>: > J Eval Clin Pract. <http://www.ncbi.nlm.nih.gov/pubmed/24819404#> 2014 > May 12. doi: 10.1111/jep.12147. [Epub ahead of print] > How evidence-based medicine is failing due to biased trials and selective > publication. > Every-Palmer S<http://www.ncbi.nlm.nih.gov/pubmed?term=Every-Palmer%20S%5BAuthor%5D&cauthor=true&cauthor_uid=24819404> > 1, Howick J<http://www.ncbi.nlm.nih.gov/pubmed?term=Howick%20J%5BAuthor%5D&cauthor=true&cauthor_uid=24819404> > . > Author information <http://www.ncbi.nlm.nih.gov/pubmed/24819404#> > Abstract > > Evidence-based medicine (EBM) was announced in the early 1990s as a 'new > paradigm' for improving patient care. Yet there is currently little > evidence that EBM has achieved its aim. Since its introduction, health care > costs have increased while there remains a lack of high-quality evidence > suggesting EBM has resulted in substantial population-level health gains. > In this paper we suggest that EBM's potential for improving patients' > health care has been thwarted by bias in the choice of hypotheses tested, > manipulation of study design and selective publication. Evidence for these > flaws is clearest in industry-funded studies. We argue EBM's indiscriminate > acceptance of industry-generated 'evidence' is akin to letting politicians > count their own votes. Given that most intervention studies are industry > funded, this is a serious problem for the overall evidence base. Clinical > decisions based on such evidence are likely to be misinformed, with > patients given less effective, harmful or more expensive treatments. More > investment in independent research is urgently required. Independent > bodies, informed democratically, need to set research priorities. We also > propose that evidence rating schemes are formally modified so research with > conflict of interest bias is explicitly downgraded in value. >