#7 is not supported in the literature but just the opposite.
--
Preston H. Long
> From: Roy Poses <[log in to unmask]>
> Reply-To: Roy Poses <[log in to unmask]>
> Date: Tue, 7 May 2002 09:33:42 EDT
> To: [log in to unmask]
> Subject: SSED (fwd)
>
> In regard to the long message by Kevin Reese....
>
> Re: 2. below. Certainly there is a lot of research on drug therapy,
> mainly because drug company regulation requires it. I've been struck by
> how little research there is on procedures (in comparison to drugs.)
> However, it's one thing to talk about the amount of research in an area.
> It's another to charge that the research has a "built in bias." Do you
> have any justification for the sweeping charge you made below?
>
>
> ---------------------------------------------------------
> Roy M. Poses MD
> Brown University Center for Primary Care and Prevention
> Memorial Hospital of RI
> 111 Brewster St.
> Pawtucket, RI 02860
> USA
> 401 729-2383
> fax: 401 729-2494
> [log in to unmask]
>
> ----------------------------Original message----------------------------
> 2. Medical research, or much of it, has an in built bias as it will endorse
> either expensive drug therapy or procedures which benefit big business.
> Regardless of what constraints are put in place this bias can not be good for
> the truthfulness of the research. The therapies are less invasive, generally
> do
> not promote a product and probably hence why they have such poor funding.
> ------------------------------------------------------------------------
>
> Re 3 below. First, I'm not sure how one goes from the "hypothetico-
> deductive model" to the mistakes you mention. Second, the mistakes must
> be balanced by the advances. For example, antibiotics certainly have
> some adverse effects, in general, I'm not sure they are very "dangerous," and
> for the patient with a bacterial infection, their benefits often greatly
> outweigh their harms. Third, the remedy for the final example of the untested
> prosthesis design would seem to be the requirement for adequate testing of
> all therapeutic interventions, not just drugs.
>
> ------------------------Original Message------------------------------
> 3. The hypothetico-deductive model of working as proposed in such systems as
> modern medical diagnosis/RCT has made some scary mistakes in the past, almost
> experimenting on it's unwitting subjects/patients. Examples include, the time
> it
> took to discover the lethal dose of digoxin, fatalities in bilateral THR's and
> angiotensinogin in burns, side effects of the contraceptive pill, the beauty
> of
> the RCT which was phalidamide and the overuse of dangerous modalities such as
> X
> Rays and antibiotics . The system still produces surgeons with the arrogance
> to
> believe that is ok to knock up a hip prosthesis in his garage and put it
> untested into a patient (actual case).
> -----------------------------------------------------------------------------
>
>
> Re 4 below. IMHO most physicians do think about the why (the etiology) too.
> There are plenty of studies of etiology in the medical literature to back
> this up.
>
> ----------------------Original Message---------------------------------------
> 4. We must recognise that there are different ways of working. Many therapists
> work on the why rather than the what basis. Eg yes the diagnosis is impingment
> of the shoulder, but why has this happened?. Treat the what without the why
> and
> it will just come back, something that the simple diagnostic model repeatedly
> misses.
> -----------------------------------------------------------------------------
>
> Ýsnip¨
> Re 7 below. Having just reviewed the JAMA article on acupuncture in
> cocaine addiction, I would change the last sentence to to say that
> the research is finally testing these modalities, with distinctly mixed
> results.
>
> -----------------------Original Message-------------------------------------
> 7. Finally it should be remembered that techniques such as
> massage/manipulation,
> acupuncture are very old medicines way pre dating antibiotics, X Rays etc. It
> is
> only recently that the establishment in medicine have relaxed their monopoly
> and
> helped and accepted much of the research is which is now proving the efficacy
> of
> these treatments.
> -----------------------------------------------------------------------------
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