The Counsel of Trent

writing is thinking

Wednesday, June 09, 2010

Evidence-based Medicine Run Amok


I'm all about the evidence. Thus, I heartily support evidence-based medicine (and frown when people go nuts over losing treatments they "believe in" "just" because there's no evidence to support its effectiveness. However, there's an application of it that I find bothersome.

There's a tendency to do the following: There a treatment T such that there is a simple, not only common sense but "causal-mechanical" analogy which supports its effectiveness in K-type cases. Yet there is no current study which verifies T's effectiveness in K. As a result, the reports will range from "It's a myth that T helps K" to "there is no reason what-so-ever" to think that T helps K. Now of course there are cases where one wants very high degrees of verification before treatment, but I'm just talking about reporting.

Here's a parody that illustrates the relevant point. A study shows that non-steroidal anti-inflammitories reduce knee inflammation. I suggest that they might also help with elbow inflammation and am met with howls and jeers, as it is pointed out to me that there is currently no study verifying their effectiveness with elbow inflammation.

The problem, of course, is a too-narrow notion of evidence. A lot of my professional work is based on clearing up this sort of confusion in philosophy and religion. People who think it's OK to believe without evidence often have a too-narrow notion of what evidence is.

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