Adam , thanks
My point was not about  the methodological and contextual nuances that may play a role in determining  the value of a particular intervention your list included, but to the text that it was obviously erroneous. The comment reads:
"Stem Cell transplantation is not recommended for at-risk AML patients in first complete remission due to poor remission-free survival in this group." However, the conclusion of the paper, which you cited clearly states" Compared with nonallogeneic SCT therapies, allogeneic SCT has significant RFS and overall survival benefit for intermediate- and poor-risk AML but not for good-risk AML in first complete remission". [the Results section state: "Compared with nonallogeneic SCT, the HR of relapse or death with allogeneic SCT for AML in CR1 was 0.80 (95% CI, 0.74-0.86). Significant RFS benefit of allogeneic SCT was documented for poor-risk (HR, 0.69; 95% CI, 0.57-0.84) and intermediate-risk AML (HR, 0.76; 95% CI, 0.68-0.85) but not for good-risk AML (HR,1.06; 95% CI, 0.80-1.42)."]
I am aware of the enormity of the task that you have accomplished. However, to make full impact, it would pay off to go over the list carefully and compare your findings/comments with (at least) conclusions of the studies you cited. 
Hope you will do it
Best
ben


-----Original Message-----
From: Elshaug, Adam Grant [mailto:[log in to unmask]] 
Sent: Tuesday, November 20, 2012 11:10 AM
To: Djulbegovic, Benjamin; [log in to unmask]
Subject: RE: List of low-value health care services and policy frame - published

Thanks, Ben, for drawing this item out. (I have been a [silent] member of the list for a few years).

Our discussion covers the limitations of the method, many of which cricle around the specificity of the process. Certainly the list contains items (or indications) it probably ought not, and others are missing that should be included. So refinement on a number of levels is needed, and members of this list are well qualified to advance the work.

We also call for more 'expert clinical detailing' to draw out points of nuance - again likely to lead to clarification of the list.

To your point about opponents if EBM: though they certainly do exist I remain hopeful that any thoughtful and constructive commentators and actors in this space (as is the case in the Australian context in which this work is based) are well-attuned to the notion that this work is not an end-product of EBM but instead a starting point. The distinction is important, I think.

All the very best,
Adam

Adam Elshaug, MPH, PhD
NHMRC Sidney Sax Fellow
Department of Health Care Policy
Harvard Medical School, Boston

Inaugural Visiting Fellow
The Commonwealth Fund, New York

Mobile: (+1) 202-600-5233
Email:   [log in to unmask]
________________________________________
From: Evidence based health (EBH) [[log in to unmask]] On Behalf Of Djulbegovic, Benjamin [[log in to unmask]]
Sent: Tuesday, November 20, 2012 8:59 AM
To: [log in to unmask]
Subject: Re: List of low-value health care services and policy frame - published

This is an extraordinary achievement, but I do worry that the list may have not been scrutinized sufficiently well. For example, a comment stating that allo stem cell transplant is not effective in AML is not accurate ( i happened to know this because I co-authored the paper). The oversights like these raise the questions about the accuracy of other statements and can be easily used by the "opponents" to discredit EBM methods.
Ash, please forward this message to Adam and ask him to double check all other entries in the list.
Thanks
Ben

Sent from my iPad
( please excuse typos & brevity)

On Nov 20, 2012, at 8:49 AM, "Ash Paul" <[log in to unmask]> wrote:

>
>
> Thanks a million Adam.
> For the benefit of the international members of our group, the full list can be obtained freely at the following appendix:
> https://www.mja.com.au/sites/default/files/issues/197_10_191112/els110
> 83_Appendix.pdf
> Regards,
> Ash
>
> ------------------------------
> On Mon, Nov 19, 2012 14:07 GMT Adam Elshaug wrote:
>
>> Over 150 potentially low-value health care practices: an Australian 
>> study Med J Aust 2012; 197 (10): 556-560.
>>
>>
>> [Open Access]
>>
>> https://www.mja.com.au/journal/2012/197/10/over-150-potentially-low-v
>> alue-health-care-practices-australian-study
>>