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BMJ Opinion: The Illusion of Evidence Based Medicine, 2022, Jureidini and McHenry (and some doctors' opinions)

Discussion in 'General ME/CFS news' started by DigitalDrifter, Apr 4, 2022.

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Do you think evidence based medicine has been compromised?

  1. Yes

    39 vote(s)
    97.5%

  2. No

    0 vote(s)
    0.0%

  3. Not sure

    1 vote(s)
    2.5%

  4. Other (Please explain)

    0 vote(s)
    0.0%
  1. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

    Messages:
    978
    https://www.bmj.com/content/376/bmj.o702
    Reddit thread:
     
    DigitalDrifter, Apr 4, 2022
    #1
    bobbler, hinterland, Hutan and 9 others like this.
  2. DokaGirl

    DokaGirl Senior Member (Voting Rights)

    Messages:
    3,664
    Not directly messing with scientific evidence, but some political leaders in Canada have removed all public health measures except vaccinations. The presumed message is the pandemic is over.

    Medical experts repeatedly state the COVID pandemic is not over. Canada is in its 6th wave, but pandemic deniers seem to have won, despite scientific evidence to the contrary.
     
    DokaGirl, Apr 4, 2022
    #2
    EzzieD, cfsandmore, MEMarge and 6 others like this.
  3. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

    Messages:
    4,350
    In relation to ME my heart always sinks when I read the phrase ‘evidence based medicine’ as it generally means bad evidence relying on bad science, more specifically unblinded trials relying on subjective outcomes.

    I also think here in the UK, as @DokaGirl suggests in Canada, policy on Covid-19 is now more about a political desire for the pandemic to be seen as over rather than the medical reality.
     
    Peter Trewhitt, Apr 5, 2022
    #3
    bobbler, Lou B Lou, Mithriel and 11 others like this.
  4. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

    Messages:
    3,956
    Location:
    Australia
    "Evidence based medicine" has always been a low bar, a minimum, not a maximum.
     
    Snow Leopard, Apr 5, 2022
    #4
    Mithriel, DokaGirl, SNT Gatchaman and 13 others like this.
  5. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    Messages:
    15,710
    Location:
    London, UK
    The other thing is that 'evidence-based' is nearly always rolled out when things are suspect - 'but we can assure you that our treatment is evidence-based'. It is mostly used precisely in those situations, like psychotherapy, where the evidence is rubbish.
     
    Jonathan Edwards, Apr 5, 2022
    #5
    bobbler, Lou B Lou, RedFox and 16 others like this.
  6. Midnattsol

    Midnattsol Moderator Staff Member

    Messages:
    3,819
    This is very much how we've been taught to deal with questioning patients in clinical nutrition.
     
    Midnattsol, Apr 5, 2022
    #6
    bobbler, RedFox, Hutan and 12 others like this.
  7. Trish

    Trish Moderator Staff Member

    Messages:
    56,497
    Location:
    UK
    The article is entirely focused on the influence of pharmaceutical companies with the dual problems of hiding data and adverse outcomes, and effect on academic research through funding.

    All important stuff and depressing that so little progress has been made on getting all protocols published in advance, all results published, and all patient level anonymised data published too, to allow open scrutiny.

    No mention of the equally harmful malign influence of insurance and government departments and research funding bodies on psychosomatic research and treatments and denial of benefits etc. for conditions without curative drug treatments, and the skewing effect of this source of funding and influence on academic promotions and 'evidence based medicine'.

    The pharmaceutical side is important, and easy to understand. Hence someone like Ben Goldacre can make his name exposing it. Those involved in making this the story public seem less inclined to take up the massive problem with psych evidence.
     
    Trish, Apr 5, 2022
    #7
    bobbler, Lou B Lou, RedFox and 14 others like this.
  8. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    Messages:
    15,710
    Location:
    London, UK
    Yes, I found it a bit dated and lacking practical insight. The senior author Leemon McHenry I know from my philosophy world. A very nice guy, interested in Whitehead, Leibniz and such people but I was not aware of an interest in medicine.

    There is a muddling up of science and evidence too. Popper was about science and theories. The medical problem is simply about having reliable facts about what treatments work, forget any theories or rational thought!
     
    Jonathan Edwards, Apr 5, 2022
    #8
    bobbler, RedFox, Joan Crawford and 10 others like this.
  9. Caroline Struthers

    Caroline Struthers Senior Member (Voting Rights)

    Messages:
    990
    Location:
    Oxford UK
    Caroline Struthers, Apr 5, 2022
    #9
    bobbler, Lou B Lou, RedFox and 13 others like this.
  10. Sean

    Sean Moderator Staff Member

    Messages:
    8,378
    Location:
    Australia
    Getting a bit tired of these kind of critiques focusing on the pharmaceutical industry. Whatever their dodgy practices might be, at least their claimed treatments have the advantage of actually being amenable to proper blinding/placebo control. e.g. Rituximab.

    Needs to be a lot more focus on the standards of non-pharmacological therapeutic claims, and their systematically inferior methodologies.

    Assuming the critics are actually interested in standards, not just bashing the pharmaceutical industry in order to promote non-pharmacological treatments.
     
    Sean, Apr 5, 2022
    #10
    bobbler, Lou B Lou, alex3619 and 12 others like this.
  11. FMMM1

    FMMM1 Senior Member (Voting Rights)

    Messages:
    2,812
    Yes it's a thing of beauty:
    "Quis custodiet ipsos custodes? (Who shall guard the guardians?) .. The current answer is ... no-one."

    Well I vaguely recall the guards calling Jonathan a pain in the flesh or some such ---- so I'd nominate you and Jonathan!
     
    FMMM1, Apr 5, 2022
    #11
    bobbler, RedFox, Starlight and 2 others like this.
  12. Caroline Struthers

    Caroline Struthers Senior Member (Voting Rights)

    Messages:
    990
    Location:
    Oxford UK
    I agree. I don't think they are really interested in standards, otherwise people like Ben Goldacre, Paul Glaziou, Paul Garner, everyone in Cochrane as far as I can tell, would not continue to ignore the shockingly poor standards in trials of behavioural and psychological treatments.
     
    Caroline Struthers, Apr 5, 2022
    #12
    bobbler, Samuel, Mithriel and 16 others like this.
  13. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

    Messages:
    978
    Agreed. The quack psychologists who had me sectioned for being bed bound (and their supporting GPs, Social workers, etc) never faced justice for the permanent harm they did. My GP claims the best evidence based treatment for ME is GET. I've been too scared to call my GP for anything since late 2014 because he condoned my sectioning.
     
    DigitalDrifter, Apr 5, 2022
    #13
    hinterland, bobbler, Lou B Lou and 18 others like this.
  14. Lilas

    Lilas Senior Member (Voting Rights)

    Messages:
    364
    Location:
    Canada
    A precision @DokaGirl: I am therefore lucky because, in my Province, the basic sanitary measures (mask in public places, physical distancing, hand washing, isolation, etc.) are still in place. And our government is following public health guidelines, no 6th wave deniers here.
     
    Lilas, Apr 5, 2022
    #14
    bobbler, Lou B Lou, Helene and 4 others like this.
  15. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

    Messages:
    978
    DigitalDrifter, May 8, 2022
    #15
    Lou B Lou, Ariel, Sean and 2 others like this.
  16. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

    Messages:
    978


    Doctors admit the truth about EBM:

     
    DigitalDrifter, Mar 3, 2023
    #16
    Sean, bobbler, Solstice and 4 others like this.

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