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Evidence Based Medicine


I was very disappointed to read that Rep Rodgers' (R-MI) amendment was accepted yesterday by the Energy and Commerce committees. 

Amednment from Rep Rodgers (R-MI) "In no case may any research conducted, supported, or developed by the Center for Comparative Effectiveness Research, the Comparative Effectiveness Research Commission, or the Federal Coordinating Council for Comparative Effectiveness Research be used by the federal government to deny or ration care."

The amendment seeks to limit the use of comparative effectiveness research.  And as a physician, I want all the evidence and research I can get to help treat my patients. 

The backbone of clinical practice is evidence based medicine.  Utilizing data to inform the treatment choices we make everyday to help our patients.  I want to eliminate treatment practices that don't help my patients....and certainly avoid at all cost doing anything that may harm my patient.  For example, hormone replacement therapy (HRT) for women.  HRT once seemed the answer for many of the conditions women face as they age. It was thought that hormone therapy could ward off heart disease, osteoporosis, and cancer, while improving women’s quality of life.  But beginning in July 2002, findings emerged from clinical trials that showed this was not so. We now know that, long-term use of hormone therapy may increase the risk of heart attack and stroke.   So, now I need to "ration" my patients use of HRT in certain circumstance in order to protect them from harm. 

The whole idea of gathering evidence and to stop using the treatments that don't work or harm patients.  So, yes....I want to deny my patients access to treatments that don't work.  And yes, I want to ration their use of treatments that have be found to be ineffective.  I hope every physician in the country would agree on this. 

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