Robert A. Hayden, DC, PhD, FICC
When we go to a doctor with a health problem, often we assume that the help we get is based on medical research. As a society, we have put much trust in research, researchers, and the integrity of the process. These assumptions give us confidence that the treatment we receive is the best possible alternative for us. This is the essence of evidence-based medicine.
You have also heard of the practice of medicine being both art and science. Sometimes your physician will make a diagnosis or select a treatment plan based on his or her experience, or what I call "gray hair." This is a valid aspect of decision-making as well. I think most decisions that physicians make are based on both the science and art of medicine. You can view this as a kind of whole brain thinking: the left brain is objective and research-based; the right brain is intuitive and creative, and it draws on experience.
All of our faith in the medical decision-making process, however, is predicated upon an assumption of integrity and honesty. There is mounting evidence that we should reconsider our assumptions.
The Chronicle of Higher Education reported on January 5, 2012 an interesting article from the British Medical Journal. That article states that researchers at Yale University recently found that less than half of 635 medical research studies funded through the National Institutes of Health (which gets $12 billion in federal funds annually) were published within 2 1/2 years of their completion. Why were the studies not published? The Chronicle reports, "The authors of the study at Yale University say that the failure to publish findings may reflect researchers who didn't get the results that save for a corporate partner wanted to see." This suggests not just bias, but perhaps researchers did not confirm what they were paid to prove, so results never saw the light of day.
Congress passed the US Food and Drug Administration Amendments Act in 2007. It requires registrants of clinical trials to keep tabs on their reports. This act did improve some on timely publication of clinical trials, but Joseph Ross, assistant professor at Yale School of Medicine, says that his study highlights a long-standing problem in biomedical research that remains: information published on the effectiveness of treatments and drugs is not as comprehensive as it could or should be.
It is horrifying to think that medical research might be done, for example, by a drug company on their own product and not reported because it did not show that it was effective. This may have happened with the drug used to treat influenza,Tamiflu. Recently, an international team of researchers and medical experts sound that Tamiflu does not do what it's prescribed to do and that the research used to back up the pharmaceutical companies claims about the is "severely incomplete." Specifically this team found that Tamiflu does not stop complications from influenza, nor does it inhibit transmission of the virus. The manufacturer of this drug claims that it does both, while the evidence is that it does neither. Consider this if Tamiflu is prescribed for you this year if there's a flu epidemic. The research behind this front line treatment may have been manufactured along with the drug.
There is a caveat emptor (Buyer beware!) lesson here. Today's health care consumer is far more savvy than those of the past, owing largely to the internet. So, research your options carefully. Read all you can find. Ask a doctor you trust for straight information. Talk to others who have your condition. Find those who have success in treating something and see what they are doing.
Such issues as this make us miss Dr. Welby all the more, don't they?