7/09/2009 05:54:00 AM
Science-based medicine? Is there any other kind?
Yes--they distinguished science-based medicine from evidence-based medicine and from complementary and alternative medicine, for example.The U.S. government has spent over $1.5 billion on research on complementary and alternative medicine, for example, since the founding of the NIH's National Center for Complementary and Alternative Medicine. Number of new treatments produced as a result of that research: 0. It's recently come out that some of that research money is going to criminals--people with felony fraud convictions. I'll have much more on this when I write up my summary (probably next week).
BTW, just to forgo the obvious question just raised by what I said--evidence-based medicine (EBM) is based on looking only at controlled trials, preferably randomized controlled trials, without regard to logic, theory, or mechanism. The speakers offered some critiques of this approach as a method for treatment selection. I raised the question of whether this requires that one must already have a plausible mechanism for the effect, arguing that this should *not* be required, and another questioner raised a similar objection about the potential for not finding a valid treatment by closing off research (i.e., making a Type II error). They seemed willing to take a more open-minded approach to EBT for research with private funds, but the NCCAM example shows that there's merit in adding some requirements for prior plausibility.
Surely science-based medicine would be evidence-based as well? The only sensible medicine should have scientific evidence that it works.
Jonathan: EBM is a specific approach to medicine that categorizes evidence in a particular way and gives no role to prior plausibility or mechanism. Science-based medicine agrees with the requirement for evidence, but it isn't EBM. It is evidence-based in the generic sense, but not in the sense of the term of art "evidence-based medicine."
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