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Firstly I find it amazing that people would argue against "Evidence Based Medicine" at all. Isn't the alternative "Medicine without a shred of evidence that it

Firstly I find it amazing that people would argue against "Evidence Based Medicine" at all. Isn't the alternative "Medicine without a shred of evidence that it works"? Why would that even deserve the name "medicine"? Secondly, I find it scary that there is so much tip-toeing around charlatans selling snake oil. It seems similar to when the British Chiropractic Society sued Simon Singh [1] for libel, and then had to back down as they couldn't actually prove that chiropracty was at all based on scientific evidence. These scammers need to be called out and challenged. If you want to sell something as "medicine" (at least in the USA) it had better get FDA approval [2], and classification as a "drug". Although this approval process still leaves the onus for testing on the drug developer, it also provides a means for FDA dis-approval if the drug is subsequently found to be dangerous or ineffective. Not perfect, but better than nothing. I really feel that science and evidence are losing in this battle due to the lack of PR and marketing. Last year saw the release of a few major studies showing the lack of strong evidence for the efficacy of multivitamins [3]. This hasn't stopped almost everyone I know from still buying and popping those pills all the time. [1]: http://en.wikipedia.org/wiki/BCA_v._Singh http://en.wikipedia.org/wiki/BCA_v._Singh [2]: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/default.htm http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugs... [3]: http://www.medicaldaily.com/vitamins-and-supplements-waste-your-money-physicians-say-265176 http://www.medicaldaily.com/vitamins-and-supplements-waste-y...

glenra 13y ago
> Firstly I find it amazing that people would argue against "Evidence Based Medicine" at all. Isn't the alternative "Medicine without a shred of evidence that it works"? You're reading too much into the name. Suppose I discover that whenever I eat carrots I get a horrible rash the next day. I track it carefully and find the effect is 100% reproducible. Eat carrots for a week, have a rash for a week; stop eating carrots for a week, it goes away. Eat them again, it comes right back. I cycle several times, the effect persists. That is pretty powerful evidence that the right medicine for my rash is to avoid eating carrots. But this sort of knowledge doesn't count as "evidence" under EBM because it wasn't part of a massive random controlled trial. And it never COULD count as evidence under EBM because nobody can profit by the advice "stop eating carrots" enough for it to be worth doing a massive placebo-controlled random trial - "not eating carrots" can't be patented. So long as FDA-type drug tests are ridiculously expensive, there is bound to be a LOT of perfectly valid medicine that IS evidence-based - there's evidence for it - but doesn't count as "evidence based medicine" according to the EBM enthusiasts.

glenra 13y ago

> Firstly I find it amazing that people would argue against "Evidence Based Medicine" at all. Isn't the alternative "Medicine without a shred of evidence that it works"? You're reading too much into the name. Suppose I discover that whenever I eat carrots I get a horrible rash the next day. I track it carefully and find the effect is 100% reproducible. Eat carrots for a week, have a rash for a week; stop eating carrots for a week, it goes away. Eat them again, it comes right back. I cycle several times, the effect persists. That is pretty powerful evidence that the right medicine for my rash is to avoid eating carrots. But this sort of knowledge doesn't count as "evidence" under EBM because it wasn't part of a massive random controlled trial. And it never COULD count as evidence under EBM because nobody can profit by the advice "stop eating carrots" enough for it to be worth doing a massive placebo-controlled random trial - "not eating carrots" can't be patented. So long as FDA-type drug tests are ridiculously expensive, there is bound to be a LOT of perfectly valid medicine that IS evidence-based - there's evidence for it - but doesn't count as "evidence based medicine" according to the EBM enthusiasts.