Comments on: GPs and the caveman approach to evidence http://northerndoctor.com/2008/10/28/gps-and-the-caveman-approach-to-evidence/ "Science is the great antidote to the poison of enthusiasm and superstition" Adam Smith. A blog from a British doctor. Mon, 06 Sep 2010 14:32:26 +0000 hourly 1 http://wordpress.com/ By: GPs and CAMapathy « Northern Doctor http://northerndoctor.com/2008/10/28/gps-and-the-caveman-approach-to-evidence/#comment-469 GPs and CAMapathy « Northern Doctor Thu, 05 Feb 2009 13:37:40 +0000 http://northerndoctor.com/?p=293#comment-469 [...] blogged before about some GP attitudes to evidence based medicine. Medicine is not a profession that particularly needs (or encourages) abstract concepts on a daily [...] [...] blogged before about some GP attitudes to evidence based medicine. Medicine is not a profession that particularly needs (or encourages) abstract concepts on a daily [...]

]]> By: northerndoctor http://northerndoctor.com/2008/10/28/gps-and-the-caveman-approach-to-evidence/#comment-313 northerndoctor Wed, 29 Oct 2008 13:41:23 +0000 http://northerndoctor.com/?p=293#comment-313 I have to admit I was thinking more towards the woo end of the market when highlighting deficiencies GPs have when appraising evidence but it is a good point re statins. At the risk of sounding like I am trying to please everyone I also think Amrchair Daddy has a point. Some of these massive trials can be pretty tricksy to critique without investing a lot of time and effort (and Big Pharma can be very efficient at subtle manipulations) - I wouldn't expect GPs to get too far with this. I also agree I would like to see much more healthy cynicism but QOF targets don't help develop that. Perhaps we can all agree that Big Pharma and CAM need watching very carefully. I will put Kendrick on my reading list. I have to admit I was thinking more towards the woo end of the market when highlighting deficiencies GPs have when appraising evidence but it is a good point re statins.

At the risk of sounding like I am trying to please everyone I also think Amrchair Daddy has a point. Some of these massive trials can be pretty tricksy to critique without investing a lot of time and effort (and Big Pharma can be very efficient at subtle manipulations) – I wouldn’t expect GPs to get too far with this.

I also agree I would like to see much more healthy cynicism but QOF targets don’t help develop that.

Perhaps we can all agree that Big Pharma and CAM need watching very carefully.

I will put Kendrick on my reading list.

]]> By: The Armchair Daddy http://northerndoctor.com/2008/10/28/gps-and-the-caveman-approach-to-evidence/#comment-312 The Armchair Daddy Wed, 29 Oct 2008 10:44:16 +0000 http://northerndoctor.com/?p=293#comment-312 The problem is that, having read a paper as best I can, I do not often find 'glaring anomolies' (anomalies?). In reality it is extremely difficult to tease out problems with research papers. I'm trying to ignore the 'one has to wonder what else they are failing to understand' bit. The problem is that, having read a paper as best I can, I do not often find ‘glaring anomolies’ (anomalies?). In reality it is extremely difficult to tease out problems with research papers.

I’m trying to ignore the ‘one has to wonder what else they are failing to understand’ bit.

]]> By: the A&E Charge Nurse http://northerndoctor.com/2008/10/28/gps-and-the-caveman-approach-to-evidence/#comment-308 the A&E Charge Nurse Tue, 28 Oct 2008 22:14:21 +0000 http://northerndoctor.com/?p=293#comment-308 Well lets take 'evidence' for the statins. The NHS spends over £1 billion on them, if we add together the actual cost of the drugs, plus blood tests/manpower, etc. Yet the cholesterol hypothesis hardly bears scrutiny - hell, there isn't even such a thing as a "cholesterol level" [since cholesterol is transported in lipoproteins and cannot be directly measured]. And even there was such a thing as a cholesterol level [which there isn't], then why does the so called "target" or threshold, presently 5 or something like that, keeps being reduced ? Take a look at Kendricks "The Cholesterol Con" - if doctors can't get a handle on glaring anomolies in research evidence for statins [particularly amongst women] then one has to wonder what else they are failing to understand, or at least adopt a healthy cynicism toward [did somebody mention SSRIs] ? Well lets take ‘evidence’ for the statins.
The NHS spends over £1 billion on them, if we add together the actual cost of the drugs, plus blood tests/manpower, etc.

Yet the cholesterol hypothesis hardly bears scrutiny – hell, there isn’t even such a thing as a “cholesterol level” [since cholesterol is transported in lipoproteins and cannot be directly measured].

And even there was such a thing as a cholesterol level [which there isn't], then why does the so called “target” or threshold, presently 5 or something like that, keeps being reduced ?

Take a look at Kendricks “The Cholesterol Con” – if doctors can’t get a handle on glaring anomolies in research evidence for statins [particularly amongst women] then one has to wonder what else they are failing to understand, or at least adopt a healthy cynicism toward [did somebody mention SSRIs] ?

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