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Evidence based medicine: red alert

Is our modern medicine Evidence Based? Absolutely not! Evidence bIased should we call it! Luckily, if we do so, we can still keep the acronym EBM. Because more then half of all the medical information in the medical journals is based on fraud, we suggest to speak of Evidence BIased Medicine! Now: an analysis of the foundation IOCOB showing the relativity of medical knowledge! With the assistance of prof.dr. Ludwig von Feyermorgen!

Facts are not facts 

Facts are facts. So it is implied by the doctors of the Association against Quackery in the Netherlands, and the government believes them. However, members of parlaiment and readers of this article, it’s completely different as you think it is. Facts are very often fabled, or adjusted to the wish of those who publish it. The facts of the ‘sacred’ medical science seems as solid as concrete fundaments. However, we will see that those are fundaments infested with moulds.

We don’t know how much we can believe of all these so called medical facts. And thereafter our society based on alle these so called facts all her medical guidelines and directives… It is such an unstable fundament. Because if you expose the medical fundaments of analysis by medical professionals from the own field….. then more than 50% of those fundaments are clearly ROTTEN!

This implies that whole virtual building of our medical guidelines and directives is also ROTTEN. And we don’t invent this here on spot. Top-epidemiologists demonstrated in November 2009 that medical facts around a modern painkiller are mainly based on fraud. And those shocking findings are not insolated findings. Here some quotes that IOCOB collected:

Massage of data

Medical literature demonstrates evidence of strong massage of data in the direction that is desired:


The medical literature therefore represents a selective and biased subset of study outcomes..
[1]

Reversal of plans and results

The research plan is often different than reporting them..:

The reporting of trial outcomes is not only frequently incomplete but also biased and inconsistent with protocols. Published articles, as well as reviews that incorporate them, may therefore be unreliable and overestimate the benefits of an intervention. [2]

The more positive the results .. the greater the chance of publication

There is strong evidence of an association between significant results and publication; studies that report positive or significant results are more likely to be published and outcomes that are statistically significant have higher odds of being fully reported. [3]

More than half is unreliable

And a Danish study shows that more than 50% of the studies are unreliable:

Outcomes in randomised trials are often reported selectively. [4]

Invent results will also help

If it doesn’t suit you, you simply invent new results..:

Of 28 primary outcomes described in the published reports, 12 were newly introduced.  [5]

Primary end points adapted..

For the skeptic the schedule from New England Journal of Medicine of 12th November 2009 over the gabapentine studies:

evidence_biased_medicine.jpeg

The Sacred science..

This all clearly demonstrates there is no sacred science, and objective facts do not exist. We seem all to be members of a tribal group and every tribal person fighting to preserve his own backyard. This applies to the GAZA-area and it applies also to medical science. The whole tribal war in our country related to alternative medicine is also a good example. Everybody islookingfor the “low hanging fruit” in order to get his right. 

This is a further reminder of how complex our ‘knowledge’ is. The discussion around the flu also a good example. Ostterhaus is PRO and Luc Bonnieux is AGAINST…. You would say, facts are facts… No so, we must learn to live with the relativity theory of medical science….

And then the encore: interest..

This is still a fact, we quote a passage from our own Dutch Journal of Medicine on 14th November 2009 under the headline: Statements on conflicts of interests are not always reliable:

A quarter of the orthopedic surgeons in 2008 were on the list as an organizer or speaker at the annual symposium of the American Academy of Orthopedic Surgeons has indication of interest to manufacturers of hip and knee prostheses dropped, according to research by Harvard Medical School. [6]

Referentie

[1] Chan AW, Altman DG. | Identifying outcome reporting bias in randomised trials on PubMed: review of publications and survey of authors. | BMJ. | 2005 Apr 2;330(7494):753. Epub 2005 Jan 28.

[2] Chan AW, Hróbjartsson A, Haahr MT, Gøtzsche PC, Altman DG. | Empirical evidence for selective reporting of outcomes in randomized trials: comparison of protocols to published articles. | JAMA. | 2004 May 26;291(20):2457-65.

[3] Dwan K, Altman DG, Arnaiz JA, Bloom J, Chan AW, Cronin E, Decullier E, Easterbrook PJ, Von Elm E, Gamble C, Ghersi D, Ioannidis JP, Simes J, Williamson PR. | Systematic review of the empirical evidence of study publication bias and outcome reporting bias. | PLoS One. | 2008 Aug 28;3(8):e3081. doi: 10.1371/journal.pone.0003081.

[4] Hróbjartsson A, Chan AW, Haahr MT, Gøtzsche PC, Altman DG. | [Selective reporting of positive outcomes in randomised trials--secondary publication.. A comparison of protocols with published reports]. | Ugeskr Laeger. | 2005 Aug 22;167(34):3189-91.

[5] Vedula SS, Bero L, Scherer RW, Dickersin K. | Outcome reporting in industry-sponsored trials of gabapentin for off-label use. | N Engl J Med. | 2009 Nov 12;361(20):1963-71. doi: 10.1056/NEJMsa0906126.

[6] Okike K, Kocher MS, Wei EX, Mehlman CT, Bhandari M. | Accuracy of conflict-of-interest disclosures reported by physicians. | N Engl J Med. | 2009 Oct 8;361(15):1466-74. doi: 10.1056/NEJMsa0807160.

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