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December 12, 2010

Has Evidence-Based Medicine Gone Too Far?

Although there is no question that evidence-based medicine is a very important development in the evolution towards higher quality healthcare, the demand for evidence for a given treatment can go too far.
The following abstract is an ACTUAL published article in the British Medical Journal describing the lack of evidence that parachutes are effective when falling out of a plane.
Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials.Smith GC, Pell JP (2003) BMJ. 327 (7429), 1459-61.

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.
Read the full text article here.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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