Evidenced Based Medicine? Think Again

I find it amusing when I am accused of practicing bad medicine because I don’t follow evidence-based medicine.  When I am confronted with this argument, I always ask, “What evidenced-based medicine are you talking about?   Is it the ghost-written articles?  Or is it the industry-sponsored articles that provide the evidence-based medicine that you make your decisions with?”

I have written about the problems with ghost-written medical articles.  What this means is that the article was written by an unidentified person.  Instead of listing the person that truly wrote the article, the medical article will be titled under someone else’s name—usually a prominent doctor.  Of course, this doctor was paid to have his/her name on the article, which gives the report more credibility.  Ghostwriting was brought to light when Big Pharma founding member Wyeth Pharmaceuticals was caught ghostwriting 26 papers promoting conventional hormone replacement therapy in different scientific journals.  Since then, it is estimated that at least 10% of all medical articles may be ghost-written.  I would bet money that the number is much higher for industry-sponsored research.

What about industry-sponsored articles?  Do you think these articles are created without bias?  The Cochrane Collaboration sought to answer this question of whether industry-sponsored articles are more likely to be biased Amazon.com $50 Gift Ca... Best Price: null Buy New $50.00 (as of 11:05 EST - Details) when compared to non-industry-sponsored reports.  (1)  I don’t think it takes much brain function to guess what the researchers found here.

In the Cochrane Review titled, Impact of Industry Sponsorship on Research Outcomes, the authors stated, “Because industry-funded research has the potential to change practice guidelines, mechanisms to reduce bias have been instituted.  Yet, industry-sponsored research still may have bias…”

The authors examined 48 papers for evidence of bias.  The outcomes studied compare the favorable results and favorable conclusions in industry- vs. non-industry- sponsored studies.  The researchers found that industry-sponsored studies had a 24% chance of having a more favorable effectiveness result when compared to non-industry-sponsored studies.  Furthermore, out of 561 studies analyzed, industry sponsored studies had an 87% chance of having a more favorable harm results when compared with non-industry based studies.

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