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Healthy Skepticism Library item: 12684

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Hopkins Tanne J.
US Institute of Medicine recommends new body to assess what works in health care
BMJ 2008 Feb 2; 336:(7638):236
http://www.bmj.com/cgi/content/extract/336/7638/236?etoc


Abstract:

The Institute of Medicine, part of the US National Academy of Sciences, recommended last week that the country needs an independent programme to evaluate “which diagnostic, treatment, and prevention services work best for various patients and circumstances.”

The institute’s report proposes a single entity to provide “credible, unbiased information.” It would be overseen by an advisory board “constituted to minimize bias,” and its scope seems to be similar to that of the United Kingdom’s National Institute for Health and Clinical Excellence (NICE).

“Under the status quo, the quality of systematic reviews is variable and findings are often unreliable even when published in peer-reviewed scientific journals,” the report says.

Hundreds, even thousands, of competing guidelines exist, and there is uncertainty about which are reliable and objective. Guidelines that are paid for by manufacturers or vendors, as many are, are more likely to show effectiveness.

“Unfortunately, the current processes underlying guideline development .

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909