Comment to the article, “Evidence-based medicine v alternative therapies: moving beyond virulence” by Kerreen Reiger, published in The Conversation:
Health claims are empiric claims. They can be tested using empiric methods. Scientific frameworks allow use to gauge the reliability of evidence. For example, the narrative claim from an individual that they were helped by chiropractic is much less useful for predicting whether chiropractic will help another individual in the future compared with evidence from a clinical trial.
This is not profound.
That medical consultations need to take into account patient values and clinical expertise is unquestioned. It is remarkable that proponents of CAM believe that non-CAM practitioners believe otherwise. All arguments that claim that the supporters of evidence-based medicine (EBM) do not hold both as important in clinical decision making should be denounced for what they are: nonsense.
The genesis of EBM is the recognition that respecting patient values, and having clinical expertise is NOT ENOUGH. The additional “special sauce” of EBM is that clinical decisions need also be informed by the best available scientific evidence. We should be mindful of the powerful cognitive biases that operate in clinical interactions, both in patients and clinicians. We should recognise that individual beliefs about health, illness and disease is not the same as empiric reality.
This article was published in Medical Observer.
Apr 23 2012
Comment: Testicular self-examination
These were comments to the article “Monday’s medical myth: testicular self-examination is a waste of time” by Mark Frydenberg, published in The Conversation.
Thank you for your opinion, Prof Frydenberg, but can this really be considered a “myth”? I appreciate that your affiliated organisation Andrology Australia recommends routine testicular self-examination, but this is not the position of the Royal Australian College of General Practitioners, nor the US Preventive Services Task Force.
If I’ve read your article correctly, your rationale is that routine self-examination will lead to earlier detection and better survival, and that it has no harm. These claims need to be examined carefully. As has been pointed out already, there is no evidence that routine screening improves survival, and indeed, it is unlikely that any screening procedure will. This is not only because testicular cancer is relatively uncommon but because treatments are so effective at all testicular cancer stages. Continue reading