Does medical science have to be adversarial to make progress? Does progress in patient care consist of weeding out treatments which are ineffective and replacing existing therapies with new and better alternatives? Subacromial Decompression (SAD) surgery is one of the most commonplace shoulder surgeries, performed regularly as a treatment for …
Do you have an idea of what makes good medical evidence in your mind? Do you have ideas about the kind of evidence you’d pay attention to, and the kind of evidence you can safely disregard? Or ideas about the evidence that would strongly sway your beliefs and actions, and …
In the early part of the 20th century, the philosopher Ludwig Wittgenstein sought to demonstrate that metaphysical claims are meaningless. Statements which couldn’t be proven true in some way—through logic or evidence—weren’t even false, they had no meaning at all. But he ran up against a problematic irony. His book, …
By definition, I begin, Alternative Medicine, I continue, Has either not been proved to work, or been proved not to work. Do you know what they call alternative medicine that’s been proved to work? Medicine. —Tim Minchin, Storm In his beat-poem Storm, the musician and comedian Tim Minchin lays …
Note: This is an abridged version of the longer article “The Dismal Disease: Temozolomide and the Interaction of Evidence“. Blockbuster drugs are rare. To be a blockbuster, a drug must shift over $1bn worth in one year. There are thousands of drugs on the market, but only a few …
“One of the best things about [extracorporeal life support] is that it acts as a parachute. It’s there when everything else fails and has known results”. Robert Bartlett 1: Parachutes and the Demand for Trials The United States Parachute Association recorded 120 deaths while skydiving in America in …
Do not centralize evidence. If you believe that all the evidence you need to make your decisions is of a single kind, you will be so much easier to mislead. Those who say ‘I’ll believe it when I see this kind of study’, once their singular preference is declared, are …
“This debate is about Britain’s greatest drug disaster. It is about the scandal of a huge United States pharmaceutical company coming to Britain and boasting of Opren, a new wonder drug to treat arthritis — with tragic results.” —Lord Jack Ashley Benoxaprofen, marketed as Opren in the UK, created a …
An abridged version of this article is also available here. Blockbuster drugs are rare. To be a blockbuster, a drug must shift over $1bn worth per year. There are thousands of drugs on the market, but only a few hundred blockbusters. Yet between them, they make up more than …
Hierarchies of Evidence are a tool employed by many advocates of Evidence-Based Medicine. They are used to appraise evidence from a range of sources, as well as to teach medical students about evidence and evidence appraisal. My PhD thesis concerns the variation in hierarchies defended, and the range of philosophical …
