Monday, August 15, 2011

Studies show we get things Wrong

Hormone Replacement Therapy (HRT), Helicobacter Pylori are just a couple of the well known instances where apparent intransigence of the medical community prevented advancement in medical treatments. Turns out we get things wrong on both sides of the coin. Ben Goldacre highlighted some research in the New England Journal of Medicine in his piece Studies of studies show that we get things wrong and in the study 

the remaining 51 were very interesting because they were, essentially, evenly split: 16 upheld a current practice as beneficial, 19 were inconclusive, and crucially, 16 found that a practice believed to be effective was, in fact, ineffective, or vice versa.

In fact in the case of HRT the limited data initially available was the best at the time and it was not until the large randomized trial showed the increased risk of heart attacks in patients taking HRT (a rise of 29%) that new information helped shape new treatments. As for Helicobacter Pylori - the cause of gastric ulcers - the ten years from

"the first murmur of a research finding to international guidelines recommending antibiotic treatment for all patients with ulcers"

May seem like a long time but assembling the trials, ensuring the safety and validating the data takes time. So while the time taken for general adoption of treatments things are not quite as bad as the conspiracy theories suggesting resistance to change and progress.

So the questions is will the increased access to large amounts of validated structured and encoded clinical data that can be compared and reconciled against patients and outcomes result in less time to get effective treatments to patients and even the potential to identify new treatments, links and causation. As far back as 1986 "Fish oil, Raynaud's syndrome, and undiscovered public knowledge" demonstrating the ability to link Fish Oil and the potential at reducing or treating Raynaud's disease. With the addition of clinically actionable data the potential to apply this as medical intelligence offers tremendous hope in accelerating the medical advancements and validating treatments faster and more effectively

Posted via email from drnic's posterous