How to survive the medical misinformation mess

[Countrygirl]

http://onlinelibrary.wiley.com/doi/10.1111/eci.12834/full

Not specifically about ME, but we can say 'Amen' to this with bells on.

Here is a small extract:

Perspective
How to survive the medical misinformation mess
Authors

• John P. A. Ioannidis,
• Michael E. Stuart,
• Shannon Brownlee,
• Sheri A. Strite

• First published: 28 September 2017Full publication history
• DOI: 10.1111/eci.12834 View/save citation
• Cited by (CrossRef): 0 articlesCheck for updates
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• Funding Information

Abstract
Most physicians and other healthcare professionals are unaware of the pervasiveness of poor quality clinical evidence that contributes considerably to overuse, underuse, avoidable adverse events, missed opportunities for right care and wasted healthcare resources. The Medical Misinformation Mess comprises four key problems. First, much published medical research is not reliable or is of uncertain reliability, offers no benefit to patients, or is not useful to decision makers. Second, most healthcare professionals are not aware of this problem. Third, they also lack the skills necessary to evaluate the reliability and usefulness of medical evidence. Finally, patients and families frequently lack relevant, accurate medical evidence and skilled guidance at the time of medical decision-making. Increasing the reliability of available, published evidence may not be an imminently reachable goal. Therefore, efforts should focus on making healthcare professionals, more sensitive to the limitations of the evidence, training them to do critical appraisal, and enhancing their communication skills so that they can effectively summarize and discuss medical evidence with patients to improve decision-making. Similar efforts may need to target also patients, journalists, policy makers, the lay public and other healthcare stakeholders.

 

[Wishful]

I think I heard about this, or at least something related, but I think it had a different name and the focus was on minimizing unnecessary medical procedures: tests that produce useless results, prescriptions or treatments that don't do anything useful (aside from giving top executives bigger quarterly bonuses), etc.

I think that a properly-designed medical self-help online service could greatly reduce the burden on the healthcare system. Doctors wouldn't be wasting time doing allergy scratch tests (50% accurate means you might as well flip a coin) or prescribing antibiotics for viral infections. Lots of complications, of course, such as making sure that people who really should see a professional do so quickly, and keeping the healthcare industry ($$$) from manipulating it for their advantage, but I think it's a good concept.

A reliable site for what tests and treatments are proven valid, and which ones haven't proven valid, would be useful too. I was just looking into cholesterol treatments, since my doctor said that my good cholesterol was a bit low and that I should take fish oil. Well, a bit of online research showed that there isn't actually any reliable evidence that fish oil supplements actually help with cholesterol levels. Lots of claims, but no clinical verification. It would be nice to have a trustworthy site to check that sort of thing.

 

[alex3619]

pdf here http://onlinelibrary.wiley.com/doi/10.1111/eci.12834/epdf

 

[alex3619]

A reliable site for what tests and treatments are proven valid, and which ones haven't proven valid, would be useful too.

These exist. They are full of misinformation. The scale of the problem is that "reliable" sources are unreliable.

 

[alex3619]

Take the PACE trial, with two Cochrane reviews supporting. it. The authors of PACE have stated in court that they were reviewers of the first. We know PD White wrote the protocol for the second. This information, and similar, formed the basis of medical guidelines around the world. I am reminded of the fad of blowing smoke up someones colon to revive them. Now we have the NIH and CDC and AHRQ and the Academy of Medicine, plus many Nobel laureates and others all distancing themselves and acting in different ways to overturn this nonscience.

These metastudies never once questioned the numerous and egregious methodological failings, or asked why one of them, which introduced severe bias into the statistics, was deliberately done. We know it was deliberate from the 2007 PDW paper.

Yet most doctors are probably still reading the CBT/GET propaganda in various sites purporting to provide reliable medical guidance. The BMJ just published a completely different guide for ME that is very different. The narrative is changing with scientists and bureaucrats around the world. The CBT/GET medical fiasco is slowly being revealed.

And still many support it.

This is not, however, an isolated event.