Re: Evidence-based medicine

[Tuan V Nguyen <t.nguyen@garvan.unsw.edu.au>]

Hi Nam,

	I am glad that you comment on this. I really want to 
learn more about the methodology of Eastern medicine. 

>>         For those of you who are not familiar with this
>> concept, let me provide you a brief summary. In the old days,
>> medicine was taught by experts in a black-and-white manner;
>> .....
>> Thus, if you want to know whether mobile phone is DEFINITELY
>> associated with cancer, you can go to search for, say, 1000
>> papers (some of which conclude yes, other conclude no) in
>> medical literature and combine the results to arrive at the
>> answer of yes/no.

>I think the concept you mentioned above may not be a new one. The
>Western medicine but not the Eastern medicine, since its dawn days and
>through its long history of development, is always considered as the
>experimental medicine, an alternative expression of " Evident-based
>medicine". 

	Western medicine and science are largely based on 
experimentation. This is, however, not equivalent to EBM. 
Unlike natural science such as mathematics where the 
Pythagoras' theorem, for example, is eternally true, 
results of experiments are not and are subject to 
advancement of science of knowledge. Thirty years ago, 
oestrogen was hailed as a wonder drug, but it is now in 
doubt whether the drug is associated with breast cancer. 
Thus, EBM is needed to evaluate treatment with all 
available evidence.

	I am not sure whether Eastern or traditional medicine 
can be said to be based on experiment from a strict sense. 
I mean, you hear that this herb treats that disease, but 
how does it work, how effective, contradiction symptoms etc 
are not well documented. I may be wrong, but you have to 
enlighten me on this.


>I wonder if there is any milestone event or period from that
>you could classify the "old day" and "these day" for this concept.

	Well, by the "old days" here I mean back to 50 yrs 
ago or so, where medicine was taught in a clear cut manner. 
Students in those days had to take the words from their 
professors, not much dispute nor argument. These days 
(about forty yrs or so), the American revolutionised the 
teaching of medicine, whereby science was introduced and 
the thinking has been shifted from memorizing facts to 
verification of facts. 


>If an issue is mentioned by 1000 papers, some say yes, some say no, this
>issue is still controversial. We can not base on yes/no ratio of these
>papers to put a yes/no confirmation for the issue.

	You are right, and that is why we need to work out 
what to believe by some weighing factor. The medical 
literature nowsadays is a JUNGLE. There are good, there are 
bad and there are ugly findings. A lot of publications in 
the old days (>50 yrs) ago were simply WRONG, I can list 
100 of examples like that. EBM was developed to screen out 
the baddies & the uglies and weigh the goodies. But, there 
are limitations as I and anh Huy have stated earlier.

	Tuan