20/20: PEER REVIEW FAILURE, HEART SURGEON GENIUS!

Matthew A. Emme emme0002 at gold.tc.umn.edu
Mon Jun 17 14:28:04 EST 1996


In article <dahmd.854.000E7910 at gate.net> , dahmd at gate.net writes:
>In article <4q1aqo$mda at epx.cis.umn.edu> Matthew A. Emme
<emme0002 at gold.tc.umn.edu> writes:
>
>>Revolutions in any field of knowledge take time to filter to the main
>>stream.  Science and medicine are notoriously conservative and need to
be
>>convinced that a given development is more substance than hype.  An
>>extension of the old saying, "Do not be the first person on the block to
>>prescribe a new drug, but also do not be the last one to."
>
>Matthew:
>
>I agree.  A very troubling trend in the past decade has been the
infiltration 
>of business ventures into medical science.  I think that when a team
launches 
>a new surgical device, medication, or treatment protocol, it receives a
lot of 
>initial publicity as the sponsoring company seeks to maximize profit
from the 
>discovery.  The media, who have become whores of the latest big headline
in 
>order to grab *their* market share, usually jump on the bandwagon.  On
the one 
>hand, the pharmaceutical companies want to recoup the millions
(sometimes 
>hundreds of millions) they have spent on the research, but on the other
hand, 
>these new "breakthroughs" are often not scrutinized like they should be
in 
>peer reviewed journals and at meetings.  


Very true.  This reminds me of a very good doc I know that will not even
talk to a drug rep about some "new and improved" drug until the doc (or
the rep) can find 3-4 well done papers from peer reviewed journals that
support what the drug company says about it.  With many of these new
drugs, there is much more hype than good studies that support there
claims and justify the offen much higher cost.


>In Ob/Gyn, for example, everybody 
>wants to be the first to try the neatest new toy, often before it has
been 
>well- tested in a true scientific manner.  We need to remember that the 
>scientific method may be painfully slow, but it is often the only way to 
>really prove a method works.



Well said!  Hindsight being 20/20 we can look back at many examples where
following the scientific method and actually rigorously testing new drugs
and procedures may have kept important things out of the main stream for
some time, but the alternative of playing fast and lose with trying to to
prove efficacy and never knowing if a new drug or treatment does what is
claimed is also a very poor option.  In the end the good ideas find their
way through the scientific method stronger for the time and most (but not
all) of the bad ideas fade away with out doing much harm (or at least
doing less harm).

IMO there is no easy answer to this trade off, but I feel that most of
the very good ideas do eventually find there way into the main stream if
the people working on them DO THE SCIENCE in such a way as to convince
the scientific community of the power of their theory.  The people that
seem to complain the most about how the medical community disregards
their ideas are offen, but not always, the ones that rely on anectode or
badly done science.  Put out good science with well done studies and
people will most offen come around.  In fact, people are lining up to
find the new "great" idea that will get them tenure or that new big grant
or the Nobel Prize.  Great ideas in science and medicine are golden and
researchers will gladly climb over each others bodies to get at the best
ideas.  On the other hand if you just go about cutting up people in the
middle of Brazil, with no follow up, no controls and very little science
to back up your opinion, it might take a little longer to change the way
the world practices medicine.  

>
>Ashley
>D. Ashley Hill, M.D.
>dahmd at gate.net
---------------------------

Matthew A. Emme     emme0002 at gold.tc.umn.edu

The three mental elements of Golf (and life): 
Belief, Vision and Method.
  
***PGP KEY AVAILABLE ON REQUEST OR KEY-SERVER****

----------------------------



More information about the Bioforum mailing list