Not the snappiest title I know! I have intended to write a post on science and evidence based medicine for a while but I didn’t know where to start. It’s a huge topic and not one that can be covered in a brief blog post.
As a scientist I have been taught to read the scientific literature, I have been taught how to conduct experiments, how to carry out statistical tests and how to weigh up evidence. These sort of things are used in science to create a hypothesis (or idea) that you then test and decide if it’s true or not. I am not a medical doctor, but part of my work involves reading and assessing clinical trials, learning about new treatments and understanding the biological reasons for side effects.
In the other part of my life, I watch TV (and adverts), read newspaper, magazines and novels. Here I come across a lot of information on complementary and alternative therapies. Articles that promote detoxing, acupuncture, homeopathy and aromatherapy to name just a few.
So what is the difference between them? Does it matter? If something helps then it must be good and if something harms then it must be bad? Right? Real life isn’t that simple. It can be hard to work out what helps long term and what feels good in the short term but first things first of all what do the names mean?
Evidence based medicine (EBM)
The use of medicine based on supportive scientific studies and the rejection of treatments that are not supported by science. It often uses the results from clinical trials to make treatment decisions.
Science based medicine (SBM)
The use of science to inform medical practice, as well as considering clinical trials it also considers preclinical research, prior probability, and consistency with current scientific knowledge.
The use of therapies such as acupuncture, yoga, Tai Chi, meditation, homeopathy in addition to conventional medical treatments such as drugs and surgery.
A broad category of treatments used instead of conventional medicine. It tends not to be approved of by medical doctors and hospitals.
It is quite common to see the term “CAM” used which stands for complementary and alternative medicine. In my experience people fall into three different categories:
- Alternative is best – Western medicine is poison, drug companies are making us ill in order to profit. Our body is mysterious and can heal itself.
- Conventional and Complementary – Accept conventional treatments but seek out complementary treatments to give themselves “the best chance”.
- Conventional is best –Alternative treatments are peddled by people trying to make money out of the sick, they don’t work and they can do more harm than good.
The subject of complementary medicine tends to provoke a lot of emotion and I have been hesitant to write about it. It’s a bit like talking politics, if you come down on once side or the other you risk losing half your audience. Some people gain a lot of benefit from complementary treatments. A lot of scientific evidence indicates that most complementary treatments have no effect.
The purpose of this blog is Understanding Cancer, from a scientific point of view, that’s not to say I don’t mention complementary or alternative treatments but that is not my main focus or expertise. There are plenty blogs, books and magazines promoting complementary and alternative medicine if you want to look for them. Likewise there are some blogs and books on evidence and science based medicine but they tend to be harder to find.
I’ve found loads of excellent and thought provoking articles on science and evidence in medicine. If you want to learn more have a look at whichever of these articles you find most interesting.
The Skeptic’s Toolbox – Toothfairy Science and other Pitfalls
I’ve got nothing to lose (click on the black box on the right to download the pdf)
Chemical Misconceptions – Making sense of chemical stories
If you are currently having treatment for cancer and find some complementary treatments helpful then don’t let me dissuade you from making the most of them. If however, you are having conventional treatment yet feel you aren’t doing “enough” because you haven’t tried a multitude of complementary treatments please take heart in the fact that while many complementary treatments can make you feel better there is no scientific evidence that they cure cancer.
I have lots more to write about science and evidence in medicine, so I imagine this will be the first post of many.