Evidence based medicine has been corrupted by corporate interests, failed regulation, and commercialisation of academia, argue these authors
The advent of evidence based medicine was a paradigm shift intended to provide a solid scientific foundation for medicine. The validity of this new paradigm, however, depends on reliable data from clinical trials, most of which are conducted by the pharmaceutical industry and reported in the names of senior academics. The release into the public domain of previously confidential pharmaceutical industry documents has given the medical community valuable insight into the degree to which industry sponsored clinical trials are misrepresented. Until this problem is corrected, evidence based medicine will remain an illusion.
The Associated Press recently ran a story they said debunked the dissenting Covid concerns of pathologist, Dr. Roger Hodkinson. In their article titled, “Pathologist falsely claims COVID-19 is a hoax, no worse than the flu,” they misrepresented several of Dr. Hodkinson’s statements. The also wrote specifically saying they were planning to debunk him, not understand what he meant. Dr Hodkinson is a medical specialist in pathology and graduate of Cambridge University, UK. He is a Fellow of the College of American Pathologists and the Royal College of Physicians and Surgeons of Canada. He was previously the President of the Alberta Society of Laboratory Physicians, an Assistant Professor in the Faculty of Medicine at the University of Alberta, and CEO of a large community based medical laboratory with a full menu of testing for infectious disease and virology. He is currently the Chairman of an American biotechnology company active in DNA sequencing.
The main purpose of science is to question and attack. To subject ideas to the greatest scrutiny. Those who decide to shut down and stifle debate – whatever they may believe themselves to be doing – are, in fact, traitors to the cause of science. Stranglers of the enlightenment, assassins of progress.
They are not alone, and things have gotten far worse in the past year or so. Science has taken a terrible battering during Covid-19, though I have always known that dissent against a widely held scientific hypothesis is difficult.
The COVID-19 pandemic has led to a surge of information being presented to clinicians regarding this novel and deadly disease. There is a clear urgency to collate, review, appraise and act on this information if we are to do the best for clinicians and patients. However, the speed of the pandemic is a threat to traditional models of knowledge translation and practice change. In this concepts paper, we argue that clinicians need to be agile in their thinking and practice in order to find the right time to change. Adoption of new methods should be based on clinical judgement, the weight of evidence and the balance of probabilities that any new technique, test or treatment might work. The pandemic requires all of us to reach a new level of evidence-based medicine characterised by scepticism, thoughtfulness, responsiveness and clinically agility in practice.