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7 April 2008

A Case Against Evidence Based Medicine?

Seb just sent this very amusing paper (which he found in a comment to a post on Andrew Gelman's blog):

Objectives: To determine whether parachutes are effective in preventing major trauma related to gravitational challenge. Design: Systematic review of randomised controlled trials. Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists. Study selection: Studies showing the effects of using a parachute during free fall. Main outcome measure: Death or major trauma, defined as an injury severity score > 15. Results: We were unable to identify any randomised controlled trials of parachute intervention. Conclusions: As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

Funny how such a lampoon can trigger a flame war on the BMJ website. Makes me understand why Gary writes about Misunderstandings between experimentalists and
observationalists about causal inference...

Posted by Jens Hainmueller at April 7, 2008 7:16 PM