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In a message dated 12/2/99 8:43:03 AM Pacific Standard Time, [log in to unmask] writes: > 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 Dear Dr Gibis: I absolutely agree!! Coming from the United States where nearly all recommendations regarding health policy result from expert opinion and not evidence, I empathize heartily with you. I think that the root of the problem is the commercial forces that promote such practices as bone density testing, including screening (probably, especially screening) These entities would for sure include the pharmaceutical companies that make the drugs used to treat osteoporosis and the companies that make the equipment to test for osteoporosis. These companies are expert at influencing the organizations that make recommendations. I am not sure how to get the organizations not to be thusly influenced, but I am persuaded that those companies are a major part of the problem. Cheers and Best Wishes, Brian .................................... Brian Budenholzer, MD Director, Clinical Enhancement & Development CC18 Group Health Cooperative; Network Services Division PO Box 204 Spokane, WA 99210-0204 USA [log in to unmask] 509/ 838-9100 X 7393 fax: 509/ 458-0368 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%