Mythology of science-based medicine

This blog emerged after reading several different articles about the state of conventional medical care and some of the misperceptions surrounding efficacy of conventional medical treatments.

First, an article titled The Mythology of Science-Based Medicine provides examples of conventional medical interventions considered to be safe, valid, or effective when in fact they lack scientific basis or have been proven ineffective. This article provides links to sources and some responses from the authors and other medical experts in the comments. Here is an addendum to that article further addressing comments.

Second, an article titled How Common Are Medical Mistakes? which delves into the startling fact that the third leading cause of death of Americans is iatrogenic causes, meaning caused by doctors, medical treatment, or diagnostic procedures.

StethoscopeFlaws of clinical trials

The “gold-standard” of medical research is the double-blind randomized controlled trial, which attempts to isolate the effect of a single intervention and control all other factors (including many features of patients such as pre-existing conditions, medications, lifestyle, diet, etc.) This makes sense in a research context but has little bearing on reality, in which medical interventions are used in conjunction with other treatments in a wide variety of patients. It is important to understand that a clinical trial is only the first step in evaluating treatment. It provides information on how something works and verifies safety in the short-term but is most definitely not a verdict on the effectiveness in the real world. This can only truly be gauged in the context of an uncontrolled patient population over time.

What about quality of life?

Something important to note about bypass surgery and angioplasty is that while they do not extend life (which is the case for many common medical treatments), this is not the only important measure to consider! Quality of life is also incredibly important and these procedures can make a major difference here. Patients with cardiovascular disease who in the past would not have these options would be severely limited by the inability to engage in even the most basic everyday activities but would also not be ill enough that they would pass away. These procedures have allowed many patients to return to a more normal level of activity and participation in life which is invaluable, even if their lifespan remains the same.

The importance of treating the cause

Regarding antidepressants, it should not be surprising that they are not very effective except in cases of severe depression. In most cases, antidepressants are the sole treatment prescribed despite mountains of evidence that combining them with other treatments (most notably psychotherapy) is far more effective.

For many patients with depression, there are valid reasons to feel depressed, such as grief, declining health, emotional stressors, post-partum changes, etc. Depression is a natural human response to life’s ups and downs. Unfortunately many of us are just not equipped to accept and work through life’s challenges on our own. Psychotherapy can be enormously helpful in arming patients with coping and self-care skills. There are also many patients for whom antidepressants are very useful in boosting them up enough so that they can actively seek other treatments to address the underlying causes of depression, but the key here is that the cause must be addressed and corrected. Otherwise antidepressants either just don’t cut it or simply mask a problem that will re-emerge once the patient discontinues the medication. This is common considering the many uncomfortable and intolerable side-effects of these medications. There are so many proven and safe treatments for depression (such as nutrition, exercise, supplements, lifestyle changes, homeopathy, therapy) that can be used in place of or in conjunction with antidepressants to achieve much better outcomes.

Trackbacks/Pingbacks

  1. Blood Type Diet lacks evidence? - Kate Whimster, Toronto Naturopathic Doctor - June 11, 2013

    […] Most lay-people would be surprised to find out that most medical interventions lack a strong evidence base proving their effectiveness.  I wrote about this in my blog Mythology of science-based medicine. […]

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