Comments on: Is evidence-based medicine desirable? http://www.kevinmd.com/blog/2007/02/is-evidence-based-medicine-desirable.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/02/is-evidence-based-medicine-desirable.html/comment-page-1#comment-72021 Anonymous Tue, 20 Feb 2007 12:47:00 +0000 http://clients.emmense.com/kevinmd/2007/02/is-evidence-based-medicine-desirable.html#comment-72021 What evidence is there that one case dealt a "severe blow" to EBM? What evidence is there that one case dealt a “severe blow” to EBM?

]]> By: Supremacy Claus http://www.kevinmd.com/blog/2007/02/is-evidence-based-medicine-desirable.html/comment-page-1#comment-72016 Supremacy Claus Tue, 20 Feb 2007 08:33:00 +0000 http://clients.emmense.com/kevinmd/2007/02/is-evidence-based-medicine-desirable.html#comment-72016 Evidence-based medicine or guidelines are trojan horses for the minimalism of the HMO. In 90% of cases they serve as a spear against the doctor not as a shield in meritless malpractice cases.<br/><br/>The doctor should consider always cross suing the arrogant academics promulgating this anti-scientific garbage fad. He should sue the individuals and the institutional enemies of clinical care and vile HMO collaborators. To deter.<br/><br/>The articles reviewed for these contain parametric statistics. These accurately reflect the larger total population of similar patients.<br/><br/>The series of single case experiments that is clinical care has a non-parametric distribution. All guidelines therefore violate the necessary assumptioms of the parametric statistics upon which the articles rest.<br/><br/>Thus all guidelines are "garbage science." Evidence-based medicine or guidelines are trojan horses for the minimalism of the HMO. In 90% of cases they serve as a spear against the doctor not as a shield in meritless malpractice cases.

The doctor should consider always cross suing the arrogant academics promulgating this anti-scientific garbage fad. He should sue the individuals and the institutional enemies of clinical care and vile HMO collaborators. To deter.

The articles reviewed for these contain parametric statistics. These accurately reflect the larger total population of similar patients.

The series of single case experiments that is clinical care has a non-parametric distribution. All guidelines therefore violate the necessary assumptioms of the parametric statistics upon which the articles rest.

Thus all guidelines are “garbage science.”

]]> By: Anonymous http://www.kevinmd.com/blog/2007/02/is-evidence-based-medicine-desirable.html/comment-page-1#comment-72008 Anonymous Tue, 20 Feb 2007 03:20:00 +0000 http://clients.emmense.com/kevinmd/2007/02/is-evidence-based-medicine-desirable.html#comment-72008 Evidence Based Medicine, as the term is now used, is useful information in certain clinical situations, but not sufficient to guide clinical decisions 96% of the time. It is a reliable guide in clinical decision making when the patient in front of you perfectly fits the study criteria--something that is rare in my specialty. Nearly all of my patients would be excluded from any of the quality studies done.<br/><br/>We all have a responsibility to follow the reasearch, then to apply that together with other sources of knowledge to the particular patient taking into account their psychology and social situation. <br/><br/>"Standard of Care" is just whatever everyone else is doing, and is a concept that does good in that it keeps us from flying off on a tangent following our own narcissistic conciets, but which also impedes innovation and advance of the art and science of medicine. Evidence Based Medicine, as the term is now used, is useful information in certain clinical situations, but not sufficient to guide clinical decisions 96% of the time. It is a reliable guide in clinical decision making when the patient in front of you perfectly fits the study criteria–something that is rare in my specialty. Nearly all of my patients would be excluded from any of the quality studies done.

We all have a responsibility to follow the reasearch, then to apply that together with other sources of knowledge to the particular patient taking into account their psychology and social situation.

“Standard of Care” is just whatever everyone else is doing, and is a concept that does good in that it keeps us from flying off on a tangent following our own narcissistic conciets, but which also impedes innovation and advance of the art and science of medicine.

]]> By: Gasman http://www.kevinmd.com/blog/2007/02/is-evidence-based-medicine-desirable.html/comment-page-1#comment-72004 Gasman Tue, 20 Feb 2007 02:27:00 +0000 http://clients.emmense.com/kevinmd/2007/02/is-evidence-based-medicine-desirable.html#comment-72004 In other words, evidence based medicine has been the touchstone of medical education, academics, and payors for more than a decade. It is now about time for the evidence that evidence based medicine works the way it claims. <br/>Time for Evidence Based Medicine to turn its critial focus upon itself. In other words, evidence based medicine has been the touchstone of medical education, academics, and payors for more than a decade. It is now about time for the evidence that evidence based medicine works the way it claims.
Time for Evidence Based Medicine to turn its critial focus upon itself.

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