Tags » Evidence Based Medicine

Evidence based medicine (EBM) not evidence-based: medicine is broken.

Re: Evidence based medicine: flawed system but still the best we’ve got Fiona Godlee. 348:doi10.1136/bmj.g440

Dear Editor,

I want to formally reject the null hypothesis of my research.(1) 335 more words

Evidence Based Medicine

Jorge Ramírez reblogged this on Chaos Theory and Human Pharmacology and commented:

Evidence Live 2015: Hierarchical levels of evidence based medicine are incorrect

“Evidence based medicine insists on rigorous standards to appraise clinical interventions. Failure to apply the same rules to its own tools could be equally damaging” – Joseph L, Ioannidis JPA, Norma T, et al. The case of the misleading funnel plot BMJ 2006; 333:597.

Aims

Hypothesis: Hierarchical levels of evidence based medicine are incorrect.

Objective

To analyze the strength of evidence provided by different types of study designs: systematic reviews and meta-analysis, controlled clinical trials, and observational studies (case-control, cohort, and cross-sectional).

Methods

Analysis of public databases (e.g., ClinicalTrials.gov, PubMed, ISI Web of Knowledge, Embase, and WHO ICTRP) according to the following variables: geographical locations, sponsors (i.e., industry and non-industry), study designs, conditions (diseases), and interventions (pharmacological and non-pharmacological). Estimation of unpublished clinical trials according to the variables listed above. Analysis of publication bias in systematic reviews and meta-analysis.

Results

Data and analysis supports the hypothesis in the title of this abstract.

Conclusions

Human pharmacology is a non-linear science created by multiple variables at different levels of complexity:
  1. Drug effects at molecular and cellular levels: drug-receptor interaction (pharmacodynamics) and drug disposition (pharmacokinetics)

  2. Effects of drugs on human health and disease: safety, efficacy, and effectiveness

  3. Effects of drugs in the society: economical aspects (i.e., pharmacoeconomics), epidemiology (i.e., pharmacological surveillance), healthcare systems (i.e., definitions of essential medicines), over the counter availability of medicines, drug addiction, and many other variables.

Hierarchical levels of evidence-based medicine (EBM) are over-simplistic to understand complex relationships involved in human pharmacology. The first EBM article matching search terms in PubMed was published in 1992. The model of drug approval into the market, as well as our methods for appraisal of the evidence involving therapeutic interventions in humans, are supported by opinions instead of real data (i.e., evidence). Evidence-based medicine is not “evidence-based”.

References

http://www.bmj.com/content/348/bmj.g3725/rr/762595 http://dx.doi.org/10.6084/m9.figshare.1093997
Ramirez, Jorge H (2015): Evidence Live 2015: Hierarchical levels of evidence based medicine are incorrect. figshare. http://dx.doi.org/10.6084/m9.figshare.1286767

Humanising Healthcare - Hope for a System under Strain

SDHI in collaboration with NHS Fife, the Scottish Improvement Science Collaborating Centre (SISCC) and the International Futures Forum (IFF) hosted an interprofessional and interdisciplinary seminar and workshop with 20 participants to envision the future  of  a  healthcare system currently under strain. 445 more words

Events

Non-event - this word of the day in dictionary has a great importance. And a common usage in medicine. It may mean an occurrence only of superficial interest,mroutine, unexceptional, unremarkable, unnoteworthy- used unsparingly. Read on..

Many a times the word uneventful may be seen in summaries that your clinician or treating physician may record in his report or history during a therapy course or at tome of discharge from a hospital stay. 316 more words

Evidence Based Medicine

News Today: Angelina Jolie has ovaries and fallopian tubes removed-But Hold on

Link to the news::: Who needs the tests such as this and what is the significance and take of masters in science. There are two tests or may be panels or gens or serum markers as we may call them in question. 487 more words

On Taking Health Advice from Gandhi... World Homeopathy Awareness Week 2015

World Homeopathy Awareness Week (WHAW) is approaching once again, to take place from the 10th to the 16th of April 2015.

Last year’s WHAW took place just as the NHMRC’s draft information paper examining evidence on the effectiveness of homeopathy in treating health conditions had been made public, which led to a substantial amount of awareness raising via the media that homeopathy is not an effective modality. 1,376 more words

Health

Mal de mer: Nausea: This dictionary word of the day means sea sickness. Lets explore what it is!

Motion sickness is a syndrome that occurs in response to real or perceived motion, which can include gastrointestinal, central nervous system, and autonomic symptoms.

Motion or sea or travel sickness is considered a physiological form of dizziness, since it is not indicative of a disease process. 159 more words