Qi Spot

Evidence Based Medicine

This article (http://www.voxy.co.nz/national/urban-myth-evidence-based-medicine/5/27647) does a good job of presenting the proof that the argument that western medicine is “evidenced based” does not hold water.  Some excerpts:

Studies from 1991 estimated that only 15% of medical interventions practiced by doctors were supported by solid scientific evidence.

More recently it has been estimated decisions made by doctors using such science ranges widely from 11% to 70%. “Hardly ringing endorsement of medicine as science” says Dr Wayne Jonas, author of the AMA’s paper `Scientific Evidence and Medical Practice’. (download PDF here)

Basically, what Jonas is saying is that (and this is especially true for general practitioners or family doctors), physicians tend to rely more on personal experience:

Primary care physicians appear to value evidence types differently than taught in standard EBM and in a way more consistent with the CAM practitioners in the study by Tilburt and colleagues.  Gabbay and le May performed an in-depth observational study of how physicians and nurse practitioners use evidence in making clinical decisions. Rather than systematic evaluation of current evidence from RCTs or even the use of current guidelines, conventional primary care practitioners rely on what Gabbay and le May called “mindlines.” Mindlines involved using tacit, internal guidelines derived from physicians’ own experiences and the opinion of colleagues in “communities of practice.” Indeed, physicians often distrusted the results of RCTs as relevant for the patients they see and instead used opinions of trusted peers.

So how does this affect acupuncture an other so-called unscientific practices?  The article says:

Wrote the study’s high ranking nursing professor authors: “If orthodox medicine is practiced on the basis of scientific evidence, as is claimed by its practitioners, such variations defy explanation,” with them adding, “… in view of such admissions, it seems incredible that medical practitioners have been trying to undermine the practice of complementary therapists because of their lack of an appropriate evidence base.”

This lack of EBM has been a criticism long levelled at holistic or natural health practitioners. Yet just as it’s being revealed how little of modern medicine actually relies on solid science, the global popularity of holistic treatments is itself driving a body of evidence proving their effectiveness. (emphasis mine)

Typical bias – those against chinese medicine will ignore all the evidence proving it, while ignoring evidence against their own positions.

Sources:

“Urban Myth? Evidence-Based Medicine” voxy.co.nz 19 October 2009.  19 October 2009 <http://www.voxy.co.nz/national/urban-myth-evidence-based-medicine/5/27647>