After my last Blog “The Three Traditions of Medicine” Some readers wanted more information about “Evidence-based clinical practice guidelines.” Here’s the standard definition: “systematically developed statements to assist practitioner decisions about appropriate health care for specific clinical circumstances. Guidelines can be used to reduce inappropriate variations in practice and to promote the delivery of high quality, evidence-based health care.”
I translate “reduce inappropriate variations in practice” as more than just prescribing the mandated drugs but to prevent doctors from looking outside the medicine cabinet when treating their patients.
What’s the ‘evidence’ that medicine wants clinical practice based upon? It’s scientific research, which is increasingly up for grabs where “Top Doctors Aren’t Disclosing Industry Ties in Medical Journal Studies.” An eye-opening LA Times article “Science Has Lost Its Way, At a Big Cost to Humanity” reports on one study. “A biotech firm, Amgen, set out to double-check the results of 53 landmark papers in their fields of cancer research and blood biology. Only 6 could be proved valid.” YIKES!
The article continues “A group at Bayer HealthCare in Germany similarly found that only 25% of published papers on which it was basing R&D projects could be validated, suggesting that projects in which the firm had sunk huge resources should be abandoned. Whole fields of research, including some in which patients were already participating in clinical trials, are based on science that hasn’t been, and possibly can’t be, validated.”
The financial implications are enormous. “The Economist recently estimated spending on biomedical R&D in industrialized countries at $59 billion a year. That’s how much could be at risk from faulty fundamental research.”
I would have liked to see more coverage of the impact on patients but unfortunately patients are rarely the most important facet in modern medicine. There is only one mention that “Whole fields of research, including some in which patients were already participating in clinical trials, are based on science that hasn’t been, and possibly can’t be, validated.”
In my book, Death by Modern Medicine, in a section called “Research For Sale”, I quote the former editor of the NEJM, Dr. Marcia Angell, who struggled to bring the attention of the world to the problem of commercializing scientific research in her editorial titled “Is Academic Medicine for Sale?”
The moral of this story? Please stop waiting for modern medicine to “save” you because the latest research on drugs and surgical procedures are being falsified under the pressure of “publish or perish” and keeping shareholders happy.
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Carolyn Dean MD ND
The Doctor of the Future®
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