More commentary on EBM

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This post on JournalClub.org makes some good points about relying solely on evidence-based medicine (and, by implication, evidence-based CME):

An implicit subtext of the evidence-based movement is that it helps counter the millions of dollars of industry propaganda and hype that wash over us every year. And EBM does, indeed, provide tools to judge drugs and interventions more objectively than we think the industry would like us to. But the drug and device industries have evolved along with (or ahead of) their customers.

Pharmaceutical companies have responded to EBM by carefully designing trials destined to apply to as wide a population as possible, while still obtaining (p<0.05) benefit. Then, armies of drug reps sally forth armed with reprints, while researchers are sent out to spread the gospel of statistical significance. EBM has made us particularly avid of hard data (while relegating clinical significance to a somewhat subordinate role). This emphasis on statistically significant data has been digested by industry and is now used to sell drugs and devices.

Something to think about, especially now when more drug data is coming under fire and CME is becoming increasingly evidence-based. As the poster says, "caveat lector."

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