There is a Lot of Science + Much of It May Not Be Reliable
Reading” a Clinical Trial Won’t Get You There
(Posted on April 27, 2015 by Sheri & Mike, Authors of Basics for Evaluating Medical Research Studies)
' There is a Lot of Science + Much of It May Not Be Reliable
Each week more than 13,000 references are added to the world’s largest library—the National Library of Medicine (NLM). Unfortunately, many of these studies are seriously flawed. One large review of 60,352 studies reported that only 7 percent passed criteria of high quality methods and clinical relevancy [McKibbon]. We and others have estimated that up to (and maybe more than) 90% of the published medical information that health care professionals rely on is flawed [Freedman, Glasziou].
We cannot know if an intervention is likely to be effective and safe without critically appraising the evidence for validity and clinical usefulness.
Failures to Understand Medical Science Basic
Many health care professionals don’t know how to quickly assess a trial for reliability and clinical usefulness.
1. Comparison group
Without a comparison group of people with similar prognostic characteristics who are treated exactly the same except for the intervention under study, you cannot discern cause and effect of an intervention because a difference between groups may explain or affect the results.
2.Presenting results as relative risk reduction (RRR) without absolute risk reduction (ARR)
A “relative” measure raises the question, “Relative to what?” Is the reported RRR in our test question 60 percent of 100 percent? Or 60 percent of 1 percent?
The two requirements are that people should be randomized as analyzed and that all people should be included in the analysis whether they have discontinued, are missing or have crossed over to other treatment arms.'
My own observations
Bias in interpreting the data depending on the educational background and experience
1. Educational background
-Conventional medicine vs hollistic
- Univeristy bias- some are more focus on prevention and minimal intervention approach
-Country of graduation intertwined with the legality of the sytem
-Year of Graduation as practice of medicine has changed due to the finacial incentives
-Funding of the educational institution- state, private or independent ( where searching for scientific truth is more important than financial profit)
2. Experience of the practitioner
- empirical data gained only through clinical application -what works and does not work
- the importance of case selection
-sources of literature used as part of further education
-the legal system in which the health practioner is practicing
There is a need for transformation in research and it's relevance to clinical practice .
There needs to be a shift from dogmatic practice from it's universal simplistic approach ( a pill for every ill) to an integration of health sciences and an awarness in the human limitations in understanding the complexity of biology.