Why Evidence-Based Medicine Doesn’t Work
This is from an Institute of Medicine report via Austin Frakt:
Indeed, the evidence base on the effectiveness of most health services is sparse. […] Well-designed, well-conducted studies of the effectiveness of most health care services are the exception, and the available research evidence falls far short of answering many questions that are important to patients and providers. […]
Commonly, researchers carefully review hundreds of references from the literature, only to conclude that no eligible study that directly addresses the question of interest exists. […]
To effectively collect the evidence on effective medical treatments will require data points from millions (possibly hundreds of millions) of observations. Add to this riddle the fact that humans vary in our blood chemistry and genetic makeup (to say nothing of epigenetics). In other words, a treatment that works for one patient may offer scant benefit to another. To ascertain which patients will benefit from a given treatment will require ever more observations and more sophisticated analysis. Although the study of the evidence upon which to evaluate treatments is a worthy goal, it’s by no means an easy one.
Fascinating! And worrisome…
Good post. I hope a lot of people read it.
Very good.
Of course, evidence-based medicine might not work even when we have the data.