The Educated Patient

Taking a Risk with a Chronic Condition

Where Science and Religion meet

If you want your healthcare experience to matter, you need to understand that healthcare speaks the language of science. It’s called evidence based medicine but researchers decide what is evidence based, not patients. Where science and religion meet is that both use dogma to support their authority. A single case report is unlikely to change clinical practice in medicine. Many single cases showing the same result are still not enough to change practice. The gold standard that might justify a review of clinical practice is the randomized control trial (RTC).

This high standard of proof is, in theory, a safeguard for patients. It means you are not subject to a snake-oil salesman telling you they can cure cancer. The RCT design is useful when testing drugs or other therapeutic interventions. The larger the RCT, the more powerful and meaningful the evidence. It’s a useful and valuable tool in some research situations.

RCT Limitations

Unfortunately, not all healthcare diseases or conditions can be measured this way. Some disease populations may never qualify for RCT investigations. I have a very rare disease and there simply are not enough patients. This makes it very difficult and expensive to test new therapies. It’s imperative, therefore, for patients to educate themselves and look for their own best option because not many scientists can.

Finally, the RCT design is not perfect. It can still result in flawed evidence, like the dietary guidelines. Without rigorous and unbiased peer analysis, it can easily become medical dogma. It can become settled science and therefore above question. I don’t think anything should ever be above question. Science can never be settled because we don’t know everything there is to know. It’s always a process of new ideas supplanting the old. This is how we acquire knowledge. It’s messy, painful and ugly. It can cause wars. It’s also unavoidable. The authoritarian dogma where science and religion meet needs to be challenged.

Categories: Risk, Uncategorized


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