“Evidence Based Medicine”… and Conflicts of Interest

This past weekend the Boston Globe published an Op Ed by Sylvia Westphal.

This past weekend the Boston Globe published an Op Ed by Sylvia Westphal.

 IN THE pursuit of safe, effective, and cost-effective medicine, evidence is king. The medical profession believes that treatments should be studied in clinical trials, then compared against other regimens, before deciding what’s best for patients. Congress and the Obama administration have strongly endorsed this process by allocating money to evaluate the most effective treatments, in order to spare the public, and insurers, the burden of unnecessary procedures.

This op-ed brings to attention the issues physicians and the public faces when considering just exactly what is implied (in reality) by the term “Evidence Based Medicine”.

We would all love to believe that the term EBM implies that a rigorously peer reviewed, conflict free article will help physicians and patients by guiding them on the appropriate treatment criterion and recommendations for a certain ailment or disease.  Unfortunately, we are learning that the conflicts of interest that exist within the medical–industrial complex frequently lead to the publication of guidelines that are sometimes not only not in the patients best interest… but are potentially dangerous.

When a physician does not possess enough evidence to recommend a certain treatment vs another, they rely on their experience, teachings and knowledge base… so called eminence based medicine.   For decades, this was the accepted standard of care.   As we peel back the layers on the processes that produce these clinical pathways or treatment guidelines, we may in-fact discover that eminence based medicine wasn’t such a bad standard after all…. ???

Stay tuned as the Evidence-Based Medicine story roars on…