The Myth of Evidenced-Based Medicine

In 1990, the Institute of Medicine recommended the development of clinical guidelines to reduce inappropriate variation in practice. This commenced an explosion of guidelines. For example, the National Guideline Clearinghouse now includes 471 guidelines for hypertension and 276 for stroke alone. For maximal variation reduction, the number of guidelines you need is one. Though it’s possible all of the hundreds of clinical guidelines on a subject say the same thing, that’s not the case.

Full Austin Frakt post worth reading.

Comments (9)

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  1. Studebaker says:

    I support the notion of evidence-based medicine. That is, I’m in favor of making decisions that history has shown to work better (or more efficiently) than others. However, I don’t support the political rhetoric that goes with it.

  2. Angel says:

    I certainly support evidence-based medicine with historical accounts of efficiency coupled with empirical scientific evidence. Politically, this is a different story.

  3. Bruce says:

    Not surprised.

  4. EBC says:

    Why not just let computers be physicians? They could decide everything based on pre-written guidelines. Just like education, and most everything, there is no “one size fits all”.

  5. RxCzar says:

    IBM’s Watson is already kicking oncologists’ butts for cancer diagnosis.

  6. Mulligan says:

    Physician guidelines sound a little like our tax code..

  7. Dr. Steve says:

    To maximize the accuracy of IBM’s Watson patients will have to be connected to a polygraph.
    But that might be next since Obama will want to know if you have guns and where they are, all in the name of health care.

  8. Gabriel Odom says:

    I posted this earlier, but I feel it’s relevant here as well:

    “The trouble is that evidence-based medicine is decades away from an exact science. Hell, the Association of periOperative Registered Nurses (AORN) has been working towards this for years. Their Perioperative Nursing Data Set (PNDS) is now in its third iteration, and they are just now starting to collect nationwide data on nursing care.”

    Until medicine is an exact science (and by exact science I mean accurate to a commonly accepted margin of error – 99.7% perhaps for acute care, 95% for non-acute care), we will have great difficulty legislating “good” medicine. This is because science has yet to fully agree on the best treatment for diseases. The human body is the most complex instrument in the universe – and we are daft to believe that the 3,500 years of “modern” medicine are enough to fully understand it.

  9. Patel says:

    So much regulations, who can actually keep track of all of this. Surely, people who make these regulations probably don’t even keep count.