Stuart Buck’s new post over at The Good Science Project has one of the hardest-hitting openings I’ve read in a while:
Many common medical practices do not have strong evidence behind them. In 2019, a group of prominent medical researchers—including Robert Califf, the former Food and Drug Administration (FDA) Commissioner—undertook the tedious task of looking into the level of evidence behind 2,930 recommendations in guidelines issued by the American Heart Association and the American College of Cardiology.They asked one simple question: how many recommendations were supported by multiple small randomized trials or at least one large trial? The answer: 8.5%. The rest were supported by only one small trial, by observational evidence, or just by “expert opinion only.”
For infectious diseases, a team of researchers looked at 1,042 recommendations in guidelines issued by the Infectious Diseases Society of America. They found that only 9.3% were supported by strong evidence. For 57% of the recommendations, the quality of evidence was “low” or “very low.” And to make matters worse, more than half of the recommendations considered low in quality of evidence were still issued as “strong” recommendations.
In oncology, a review of 1,023 recommendations from the National Comprehensive Cancer Network found that “…only 6% of the recommendations … are based on high-level evidence”, suggesting “a huge opportunity for research to fill the knowledge gap and further improve the scientific validity of the guidelines.”
Even worse, as shown in a great book co-authored by current FDA official Vinay Prasad, there are many cases where not only is a common medical treatment lacking the evidence to support it, but also one or more randomized trials have shown that the treatment is useless or even harmful!
(I’ll refrain from quoting the rest and suggest instead you check out his post)
sent to my dad who is an editor at FPIN. I think he only quickly skimmed it so grain of salt here but this is what he had to say.
“I already know that we waste a lot of money on things that don’t work or work poorly. Knowing that they don’t work has not yet been enough.”
and
“China may be able to do the plan as described because of their command economy rather than the influence wielded by the groups the article described as barriers.”
Stuart Buck’s new post over at The Good Science Project has one of the hardest-hitting openings I’ve read in a while:
(I’ll refrain from quoting the rest and suggest instead you check out his post)
sent to my dad who is an editor at FPIN. I think he only quickly skimmed it so grain of salt here but this is what he had to say.
“I already know that we waste a lot of money on things that don’t work or work poorly. Knowing that they don’t work has not yet been enough.”
and
“China may be able to do the plan as described because of their command economy rather than the influence wielded by the groups the article described as barriers.”