I shudder when I encounter the words “studies show” or “clinical evidence indicates.”
Evidence-based medicine is valuable only to the degree that what is presented is done so in a thorough, encompassing way.
Many of the studies I read to stay abreast of what’s trending in the Psychopharmacology field aren’t worth the paper they’re written on or the cyberspace in which they’ve been transmitted. Take the FDA approval process for example. All that’s needed to pass FDA muster is that a potential new drug candidate outperform placebo. In blunt terms, it needs to beat out sugar. The fact is many of these drugs are weakly beating placebo! We’re supposed to be excited about that? As a consumer, an informed prescriber or Psychopharmacology speaker (me), you want to know how well a possible newcomer stacks up against the existing competition. That is, you want to know how it ranks head-to-head compared to other established agents within the genre. This is a real weakness with the FDA approval process, and I should add that it’s a process and content problem with all medication classes within the bounds of physical and mental health medicine.
As consumers, when we’re bombarded by direct-to-consumer advertising to buy something, our dukes go up because we’ve learned the hard way that it’s vital we protect ourselves from misrepresentation and outright fraud. By contrast, we healthcare professionals tend to have very little skepticism when it comes to what we read and digest in medical journals.
Realize that the peer review system is not perfect and is subject to publication bias and that a study which reads professionally and is footnoted to the hilt doesn’t necessarily render it credible. “Studies” and “clinical evidence” should be but one component of your overall decision-making. Also, look for who published the data – that is, consider the source. If the authors are employees of the pharmaceutical company, or if they’re in the company’s speakers’ stable, be wary and takes those conflicts into account.
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