Print

Print
-Richard Horton has his own opinion:
Their point was that most clinical decisions lie in a grey zone—there is no single right answer for everyone. The important step is less to adhere to some abstract notion of EBM, but rather to think hard about what kind of medical mindset you have. Whether you are a maximalist-believer or a minimalist-doubter will have a larger effect on your clinical decisions than the result of any single systematic review or randomised trial. We see these mindsets at play all the time in today's scientific, evidence-informed medicine. There have been at least four US expert committees ruling on the safety and efficacy of screening mammography—with four different sets of recommendations. There have been three expert committees reviewing the evidence on screening for prostate cancer using PSA—with three different conclusions. So much for science. So much for evidence. What matters more are the mindsets of those “experts” reviewing the scientific evidence. Here is The Donald Trump Promise, according to Groopman and Hartzband. Modern scientific medicine promises the right doctor prescribing the right treatment and the right procedure for the right outcome. It's just impossible. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31657-4/fulltext
-un saludo juan gérvas @JuanGrvas

2017-06-16 7:08 GMT+02:00 Jordan Panayotov <[log in to unmask]>:
To paraphrase Ioannidis, while being on the same page, I fully agree that:

Academic publishing has become a business, mostly serving vested interests of: 
No.1 Publishers , making $$ billions every year by (illegally) claiming copyright to public intellectual property (most research is funded by the public, thus the 'product' belongs to the public, and not to researchers who do not have right to assign copyrights to the publisher!) For example, I have to pay US$ 35.95 just to see this paper!?!
No.2 Medical/Pharma industry that sell their products for $$ billions every year (remember Tamiflu?), based on the "Evidence" from published papers. 
No.3 Academic researchers who get public money (grants) based solely on number of their publications.

Apparently, today academic publishing has deviated so significantly from it's originally declared goal - to disseminate knowledge, that almost nothing of this goal has remained.
Disseminating knowledge has become a collateral benefit for few, while serving the main goal of maximizing income/profit of the three beneficiaries above.
For example, I have to pay US$ 35.95 just to see a paper!?!

Who benefits out of this totally corrupt way for disseminating knowledge?
Answering this question can set the right fundament for designing a new way for disseminating knowledge, which will bring the EBM to it's original purpose.

Jordan



From: Anoop Balachandran <[log in to unmask]>
To: EVIDENCE-BASED-HEALTH@JISCMAIL.AC.UK
Sent: Thursday, June 15, 2017 8:18 AM
Subject: Hijacked evidence-based medicine

New article from Loanniddis : Hijacked evidence-based medicine: stay the course and throw the pirates overboard.

The article discusses a number of criticisms that have been raised against evidence-based medicine, such as focusing on benefits and ignoring adverse events; being interested in averages and ignoring the wide variability in individual risks and responsiveness; ignoring clinician-patient interaction and clinical judgement; leading to some sort of reductionism; and falling prey to corruption from conflicts of interest. I argue that none of these deficiencies are necessarily inherent to evidence-based medicine. In fact, work in evidence-based medicine has contributed a lot towards minimizing these deficiencies in medical research and medical care. However, evidence-based medicine is paying the price of its success: having become more widely recognized, it is manipulated and misused to support subverted or perverted agendas that are hijacking its reputation value. Sometimes the conflicts behind these agendas are so strong that one worries about whether the hijacking of evidence-based medicine is reversible. Nevertheless, evidence-based medicine is a valuable conceptual toolkit and it is worth to try to remove the biases of the pirates who have hijacked its ship.

I have wrote this quite a few times in this forum: Most of the criticisms against EBM are not actual criticisms of EBM, like EBM ignores the patient, conflict of interest and so forth. Glad to see the article since many people were using his articles to chastise EBM.