{"id":1197,"date":"2015-11-17T20:55:57","date_gmt":"2015-11-17T19:55:57","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc\/?p=1197"},"modified":"2015-11-14T21:34:22","modified_gmt":"2015-11-14T20:34:22","slug":"interventions-without-evidence-should-not-be-undertaken-discuss","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2015\/11\/17\/interventions-without-evidence-should-not-be-undertaken-discuss\/","title":{"rendered":"Interventions without evidence should not be undertaken. Discuss."},"content":{"rendered":"

\"1024px-Debate_Logo.svg\"<\/a>It’s been a ‘debate topic’ from a number of conferences, medical student\u00a0societies and online fora.<\/p>\n

Should an intervention without\u00a0evidence ever be undertaken?<\/p>\n

There’s a couple of key elements here: one – the idea that there can be an intervention ‘with no\u00a0evidence’, and two – that an absence of evidence should be interpreted\u00a0an evidence of absence of effect. Both are straw men.<\/p>\n

We’ve covered this ground before. We’ve battered on about the need of #realEBM to be the combination of best available evidence, viewed through a lens of clinical expertise and decided in conjunction with patients <\/a>to make an appropriate choice. And that ‘best available’<\/a> means exactly that – so\u00a0that for some things there are multiple, well conducted RCTs, for others there is a report that once, someone with a similar condition got better. Sometimes there is even less – it truly is a never previously done – but in those cases we should be talking about research, not EBM, shouldn’t we?\u00a0Beyond that, there’s a way of thinking about an\u00a0parachute of evidence – some of it direct, much of it indirect.<\/p>\n

Then there’s the idea that if you don’t have evidence of something working, it doesn’t work. \u00a0Hmmmmmm.\u00a0Now there is a difference between “This ultraviolet pen torch might well cure your glioblastoma multiforme” and “Intranasal diamorphine has good analgesic effects, I wonder if intranasal oxycodone might?”. That’s a basic issue of functional credibility. But there’s also just the issue of precision, uncertainty and truth – I don’t know is different than I know it’s not<\/a>.<\/p>\n

So. It’s not a question to debate. It’s a question to unpick. And reject as fundamentally failing to understand RealEBM<\/p>\n

– Archi<\/p>\n","protected":false},"excerpt":{"rendered":"

It’s been a ‘debate topic’ from a number of conferences, medical student\u00a0societies and online fora. Should an intervention without\u00a0evidence ever be undertaken? There’s a couple of key elements here: one – the idea that there can be an intervention ‘with no\u00a0evidence’, and two – that an absence of evidence should be interpreted\u00a0an evidence of absence […]<\/p>\n

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