the case against evidence-based medicine

THE CASE AGAINST EVIDENCE-BASED MEDICINE

“When I tell friends outside medicine that many papers published in medical journals are misleading because of methodological weaknesses they are rightly shocked. Huge sums of money are spent annually on research that is seriously flawed through the use of inappropriate designs, unrepresentative samples, small samples, incorrect methods of analysis, and faulty interpretation.”  Dr. Doug Altman (statistician) from a January 1994 editorial published in one of the oldest and most prestigious medical journals in the world; British Medical Journal (The scandal of poor medical research).  Altman concluded that, “The poor quality of much medical research is widely acknowledged, yet disturbingly the leaders of the medical profession seem only minimally concerned about the problem and make no apparent efforts to find a solution”.   “Twenty years later I fear that things are not better but worse…  Sadly, the BMJ could publish this editorial almost unchanged again this week“  Past editor of BMJ, Dr. Richard Smith, writing about the article above in the January 31 edition of the British Medical Journal’s blog (Medical Research — Still a Scandal). Smith went on to say that, “I wasn’t shocked when we published Altman’s editorial because I’d begun to understand about five years’ before that much research was poor.”

Years ago I was at a chiropractic conference in Atlanta, where I met a fellow chiro from South Carolina.  He was telling me about his Ph.D neighbor, whose job it was to create studies for the tobacco industry that proved smoking was not as all-fired bad for people as scientific evidence had led them to believe.  Is the same thing going on today in the Medical Research Community?  Do you really need to ask?  Sure it is — particularly when you realize that corporate medicine dangles like a puppet at the ends of the strings attached to Big Pharma’s fingers.  And the amazing thing is, it’s not just a crazy chiropractor from the hills of southern Missouri telling you about this problem and the fact that it is getting worse.  The voice in the wilderness is getting louder, and is coming from some of the most elite people in their respective fields, publishing in some of the most respected publications on the planet.  Some of the problems that Richard Smith specifically mentioned in his recent article included thing like…..

• INCREDIBLE WASTE:   In the September 2009 issue of The Lancet, doctors Iain Chalmers and Paul Glasziou published an article called Avoidable Waste in the Production and Reporting of Evidence.  Astoundingly, they showed that 85% of the monies spent on medical research is wasted.  Re-read that sentence and let it sink in for a moment — especially in light of the fact that most of that money is coming out of your pocket in the form of hard-earned tax dollars.  Just last month, The Lancet revisited this topic with an entire series of articles.  You ticked off yet?  If not, just stick around and you will be!

• RESEARCH IS OFTEN BIASED:  I know you’ll find this difficult to believe — particularly in light of the story about the tobacco researcher above — but it’s true.   It is all but completely impossible to trust research / researchers when so much MONEY IS AT STAKE.  Probably the only industry bigger than Big Pharma is Big Oil.  When a certain drug company gives John Q Public University 500 million dollars to build the SquibbMerleCo. Research Center smack-dab in the middle of their campus, do you think that the doctors hired to do the research are going to come up with results that show that SMC’s drug is ineffective or harmful?  Not if there is any way around it.  It’s the very reason that drugs like PREGENTITORIVOX get OK’d in the first place.  And if the research is too bad to ignore.  That’s even easier to deal with.  Just bury it as though it never existed.

• INVISIBLE & ABANDONED STUDIES:  I recently wrote a THREE PART SERIES on this little known problem.  Smith sums the situation up nicely when he says that, “the research that is completed is not made fully accessible. Half of studies are never published at all, and there is a bias in what is published, meaning that treatments may seem to be more effective and safer than they actually are. Then not all outcome measures are reported, again with a bias towards those are positive.”  Think about this for a moment.  All you have to do to skew the results of research in your favor is to only publish favorable studies.  The ones that turned out poorly for the company funding the research?  They never happened.

WHY IT MATTERS

Many of you reading this are saying, “who gives a rip?  I can’t change the system.  And what the heck does it matter anyhow“?  Trust me; it matters a lot — particularly in this age of EVIDENCE -BASED MEDICINE that is absurdly bureaucratic and increasingly controlled by our federal government.  What happens when you don’t want your child to have a CT SCAN to look at an appendix that obviously needs to come out?  What happens when you DON’T WANT A FLU SHOT (or for that matter, any other VACCINES) because you have actually done your homework?  What about forcing medications or procedures on people?  Trust me folks; it’s coming.

Because the American people have turned healthcare over to our government, our government will soon be making virtually all of the big healthcare decisions for you and your family — particularly those that are supposedly in the interest of “Public Health”  Slightly HIGH CHOLESTEROL?  You’ll be forced to take a STATIN DRUG. Having a hard time with DEPRESSION?  You will be made to take ANTI-DEPRESSANTS.  Don’t want your child who is struggling with CHRONIC EAR INFECTIONS to be given ANTIBIOTICS, but instead to be treated by a Chiropractor?  Trust me when I tell you that in your lifetime ( assuming the ZOMBIES have not taken over first), you will be spoon-fed healthcare in whatever doses the government deems fit to dole them out in.  Why do you think that the drug industry did not really put up a fight against the ACA?   It’s because they are going to make a killing.  And just remember; it might be you that is on the receiving end of that killing (HERE).