Evidence Based Concept
It is standard medical policy to judge treatments based on EBM, or ‘evidenced based medicine’. This term is laudable and reflects the need to protect the patient from potential harm and to provide proven, safe treatments.
Unfortunately the concept can be used by self-interest parties to shut down very worthwhile treatments which have an excellent record of benefit, minimal if any harm – but lack the much touted RCT – randomised clinical trial. Such trials are extremely expensive and almost exclusively confined to pharmaceutical chemicals.
Small trials, evidence from case studies and observation over time can be valid parameters of evidence. We are only too aware of the EBM drugs that have taken a toll on morbidity and mortality – to be eventually withdrawn from the market and not too promptly I should add.
So the EBM model is a good concept but must be used wisely – not as a political device.
“Ultimately, medicine has a single aim: to relieve human suffering and promote wellness. When measured against this benchmark, different therapies should be seen on a spectrum ranging from effective to ineffective rather than as ‘orthodox, mainstream’ or ‘unorthodox, non-mainstream’. More so, any therapy choice should cause least, preferably, no harm. These two themes must influence treatment choices.
No single professional group has ownership of health, and the best healthcare requires a multidisciplinary approach. Thus there is an imperative for all healthcare professionals to work together for the benefit of their patients and the wider community – prejudices should be cast aside.”
This well balanced discussion of the use of evidence based medicine is taken from the website of Dr Bill Reeder, an integrative practitioner in New Zealand. http://www.medcom.co.nz/