Healthy Skepticism Library item: 15939

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

Hirsh J, Guyatt G.
Clinical experts or methodologists to write clinical guidelines?
Lancet 2009 Apr 24;
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60787-X/fulltext

Abstract:

The guidelines by the American College of Chest Physicians (ACCP) on antithrombotic therapy, first published in 1986 and subsequently every 4 years, have become an institution. 1 One of us (JH) was a founding editor and retired from that position in June, 2008; the other (GG) has been an editor for the past three iterations. Although the ACCP guidelines have had an important impact on patients’ care, we have become increasingly aware of their deficiencies and of deficiencies of clinical guidelines …

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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