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Healthy Skepticism Library item: 19083

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: Report

El dilema de las Guías Clínicas
No Gracias 2011
http://www.nogracias.eu/v_portal/informacion/informacionver.asp?cod=7639&te=&idage=&vap=0&codrel=642


Abstract:

Las guías clínicas son enormemente influyentes: los médicos sin tiempo para conocer todas las evidencias por si mismos, han de confiar en ellas. En la mayoría de las guías constan los conflictos de interés de los autores, que en su inmensa mayoría mantienen algún tipo de relación con la industria. El profesor Choudhry de Harvard, (Boston, Massachusetts) encontró que el 87% de los autores tenían vínculos con las compañías farmacéuticas, y en el 59% las relaciones afectaban a medicamentos que estaban incluidos en las directrices (JAMA 2002; 287:612-7). En realidad, la mera declaración de conflictos de interés, no elimina los posibles sesgos porque su influencia pueda pasar desapercibida y es difícil de evaluar para los lectores de las guías. Aunque la prohibición de vínculos con la industria no es realista, es necesario definir mejor los sesgos potenciales para poder excluir o sólo divulgar los conflictos que están en juego.

 

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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