Saturday, April 22, 2006

How Evidence Based Medicine Can Be Used Against Patients.

Evidence-based medicine - Wikipedia, the free encyclopedia:

"In managed healthcare systems evidence-based guidelines have been used as a basis for denying insurance coverage for some treatments some of which are held by the physicians involved to be effective, but of which randomized controlled trials have not yet been published."

I blogged on Orac's website about how I think medicine is a science more than an art, and I wondered at the end if evidence based medicine had any downsides. Apparently it does. Having personally experienced the downsides I was not surprised to read this, but I am annoyed. Read the Wiki to find out what evidence based medicine should be based on and how it can be stymied. There are a number of problems with switching teams in any circumstance, but the denial of care because there is no evidence should not be one of them. If I sound like I am talking out of both sides of my mout, please try to follow me. If there is science behind a treatment- even if it is veterinary science- the procedure should not be considered experimental. It should behoove the great and grand insurance companies to find a way of actually assessing evidence on procedures. It should be an open process, and it should be done not to deny care but to provide the best alternative to patients. Patients are not populations, so as genetic understanding of health grows, this information should be incorporated into the body of knowledge. Financial and political pressures should not come into play like they did recently with the FDA decision to ignore marijuana's efficacy for certain conditions.

First we need brain transplants for non-thinking patients and doctors. Or real schools where real critical thinking skills are taught and valued and rote learning is seen as an adjunct not a means to an end.

I was pleased to note that there is a genetic basis for Chronic Fatigue Syndrome. That is an extremely contentious diagnosis that real people are psyched to death for.

Will the Internet advance more open communication between medical players?? I would like to think this is possible, but given how much is at stake, I am certain it will be a fight to the death for some.


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