Editorial Issue 191

I don’t suppose I am unique, but for me 2011 was an annus horribilis (I have been intending to blog about why, but haven’t yet found the time); I have been quietly thrilled that 2012 has arrived. Despite the continuous never-ending onslaught of doom-ladened media reports about financial meltdown and political back stabbings, everybody I speak with in the natural health universe have got their heads down and are slaving away with their patients, courses, products and events.

Back

This morning I heard a radio interview discussion that contrary to the so-called prevailing business trends in companies for general managers, openness and transparency about their activities, that Apple, arguably one of the top performing companies, bucks this trend, selecting specialist managers with expertise and is highly secretive about what they are doing.

Evidence-based medicine (EBM) is a similarly fundamentalist ‘truism’ which appears to have been embraced by much of the medical and pharmaceutical establishment. I have enjoyed ranting about the failings and imperfections of EBM in various PH Online Editorials; however recently I read the latest issue of Leon Chaitow’s Journal of Bodywork & Movement Therapies with possibly the most thorough and learned critique of evidence-based medicine (EBM) by Anthony L. Rosner PhD LLD[Hon.] LLC.[1]

“Evidence-based medicine (EBM) is beset with numerous problems. In addition to the fact that varied audiences have each customarily sought differing types of evidence, EBM traditionally incorporated a hierarchy of clinical research designs, placing systematic reviews and meta-analyses at the pinnacle. Yet the canonical pyramid of EBM excludes numerous sources of research information, such as basic research, epidemiology, and health services research. Models of EBM commonly used by third party payers have ignored clinical judgment and patient values and expectations, which together form a tripartite and more realistic guideline to effective clinical care. Added to this is the problem in which enhanced placebo treatments in experimentation may obscure verum effects seen commonly in practice.

“Compounding the issue is that poor systematic reviews which comprise a significant portion of EBM are prone to subjective bias in their inclusion criteria and methodological scoring, shown to skew outcomes. Finally, the blinding concept of randomized controlled trials is particularly problematic in applications of physical medicine. Examples from the research literature in physical medicine highlight conclusions which are open to debate. More progressive components of EBM are recommended, together with greater recognition of the varying audiences employing EBM.”

www.sciencedirect.com/science/journal/13608592

http://www.sciencedirect.com/science/article/pii/S1360859211000751

This PH Online February Issue 191 is extremely strong and varied in editorial features, with articles about Crystals, Past Lives, Hypnosis for Obstetrics and Skin Conditions, Self-Help Reflexology, Probiotics for a Healthy Gut, Seaweed for Colon Health, How Allergies can Devastate our Lives yet can also be Overcome, Bodywork features about how imperfect Cast Removal in Children can result in long-standing complications and Muscle Energy Techniques (MET) applied to Knee Pain.

http://www.positivehealth.com/issue/issue-191-february-2012

One good thing that has happened is that my partner Mike’s urinary enlarged prostate saga appears to have come to a happier outcome than I had been fearing. For those of you who have been following this mini-saga over the past 3 months or so, you may recall that as we were publishing the Jan Issue 190, Mike had returned from hospital, but still with a catheter. In order to lose this intrusive device he had to pass the urinary trial without catheter trial with the specialist nurse at the hospital. On 30 Dec, just a couple of days prior to 2012, he managed to pass the test, albeit with some reservations from the nurse. So he had to return a few weeks later to repeat this test, to ensure that he was emptying his bladder.

I am happy to announce that he passed this test again and has been discharged. The biopsy results on the prostate tissue removed were entirely benign; his condition has been improving and he is looking forward to being able to resume his exercises which caused his hernia in the first place.

I guess one of the lessons I have learned is that as we get older, the problems we encounter are ones with which we are not familiar. Long live TURP.

References

1. Anthony L. Rosner PhD LLD[Hon.] LLC. Evidence-based medicine: Revisiting the pyramid of priorities. Journal of Bodywork & Movement Therapies 16: 42-49. 2012.