“Yet prediction is not trivial or easy. In fact chaos, the mainspring of this article, has shown us that predictability is the exception rather. than the rule, even for what seem like simple physical systems. A human being is immeasurably more complex than any demonstrably chaotic system-the question can be turned around: How can anything be predicted about a person?”
―Firth WJ. Chaos–predicting the unpredictable. BMJ. Dec 21, 1991; 303(6817): 1565-1568. http://dx.doi.org/10.1136/bmj.303.6817.1565
MeSH entry terms: “nonlinear dynamics”
Non linear Dynamics
Non linear Models
“I believe in deeply ordered chaos.” ―Francis Bacon.
Chaos begins in this blog… 3… 2… 1…
View more of Lorenz designs by Emerson Taymor on Flickr
Time is relative: Welcome to my blog: Chaos Theory and Human Pharmacology
I want to formally reject the null hypothesis of my research.(1)
I respectfully disagree with the statement about EBM in the title of this article: “flawed system but still the best we’ve got.”
I think is quite the opposite: it is probably the worst we’ve got.(2)
You mentioned Winston Churchill in this paper and I would like to quote him: “We shall not surrender.”
The strength of evidence has been frequently represented as a pyramid: there is no pyramid of evidence – it is a collective delusion and now medicine has been severely broken.
We must fix medicine now, but first we must recognize that EBM is not evidence-based and it is causing medicine a great damage. We need to stop this nonsense now before it’s too late.
It was already predicted by one of the most cited EBM (position 28th out of 9.476 articles) articles on ISI Web of Knowledge (2001 – 2014).
“If treatment decisions are made on the basis of misleading methodological tests, the costs to patients and society could be high.” (3)
The most cited articles regarding EBM are:
1st. Surviving sepsis guidelines: 2008 (2303 citations)
2nd. Surviving sepsis guidelines: 2004 (1571 citations)
3rd. to 50th. Available on reference number 4.
This is also evidence that citations do not reflect the quality of an article, as well as the impact factor does not accurately measure the reputation of a peer-review journal.
I will submit my research findings hoping to receive a strict prepublication and postpublication peer review according to the best available evidence.(5)
1. Hierarchical levels of evidence based medicine (EBM) are wrong.
2. Is the pharmaceutical industry like the mafia? Yes.http://blogs.bmj.com/bmj/2013/09/10/richard-smith-is-the-pharmaceutical-…
3. Lau J, Ioannidis JPA, Terrin N, et al. The case of the misleading funnel plot. BMJ 2006;333:597–600.doi:10.1136/bmj.333.7568.597
4. Chaos theory to evidence-based medicine: Hello!
URL: http://wp.me/p4UVo9-5z (date accessed: Dec 17, 2014).
5. Evidence based publishing. URL: http://www.bmj.com/about-bmj/evidence-based-publishing (date accessed: Dec 17, 2014).
Competing interests: Non-financial conflict of interests
Originally posted as a rapid response – Letter to The BMJ Editor –
Evidence based medicine (EBM) not evidence-based: medicine is broken.
Re: Evidence based medicine: flawed system but still the best we’ve got Fiona Godlee.348:doi10.1136/bmj.g440
Hierarchical levels of evidence are supported by opinions (i.e., lowest strength of evidence according to EBM) instead of real data collected from different types of study designs (i.e., evidence).
Mafia has been defined since 1940 as a “group regarded as exerting a secret and sinister influence”.(1)
I know how these groups operate because I have been living in Colombia since 1981. In this South American country, drug cartels were very effective at infiltrating and corrupting all levels of society, their criminal activities were only possible by the complicity of many persons obtaining benefits from these mafia organizations, either directly by being part of their payroll and/or indirectly by providing services and commodities. Those who stand on the side of righteousness were brutally murdered.
“Democracy is not defended by the violation of human rights” – Rodrigo Lara Bonilla.*
” Tolerance is the virtue of those who have faith in what we believe ” ―Alvaro G. Hurtado**
I have been analyzing data about evidence-based medicine during the last six months.(2) One of my conclusions is described in the following quote of my analysis: “The effect of criminal practices by pharmaceutical companies is only possible because of the complicity of others: healthcare systems, professional associations, governmental and academic institutions.”. Read more via figshare. (2)
Finally, I would like to agree and endorse Dr. Smith conclusions about the outstanding work by Peter C. Gøtzsche “Critics of the drug industry have been increasing in number, respectability, and vehemence, and Peter has surpassed them all in comparing the industry with organised crime. I hope that nobody will be put off reading this book by the boldness of his comparison, and perhaps the bluntness of the message will lead to valuable reform.”
2. Ramirez, Jorge H (2014): Data (i.e., evidence) about evidence based medicine. figshare.http://dx.doi.org/10.6084/m9.f…
Original quotes (Spanish language):
*“La democracia no se defiende violando los derechos humanos”
**”La tolerancia es la virtud de quienes tenemos fe en lo que creemos”
Read the original response: BMJ Blogs
Image credits: Médicos Sin Marca
“The effect of criminal practices by pharmaceutical companies is only possible because of the complicity of others: healthcare systems, professional associations, governmental and academic institutions. Pharmaceutical companies also corrupt at the personal level, politicians and political parties are on their payroll, medical professionals seduced by different types of gifts in exchange of prescriptions (i.e., bribery) which very likely results in patients not receiving the proper treatment for their disease, many times there is no such thing: healthy persons not needing pharmacological treatments of any kind are constantly misdiagnosed and treated with unnecessary drugs. Some medical professionals are converted in K.O.L. which is only a puppet appearing on stage to spread lies to their peers, a person supposedly trained to improve the well-being of others, now deceits on behalf of pharmaceutical companies. Probably the saddest thing is that many honest doctors are being misled by these lies created by the rules of pharmaceutical marketing instead of scientific, medical, and ethical principles. Interpretation of EBM in this context was not anticipated by their creators.” –Read more: http://dx.doi.org/10.6084/m9.figshare.1093997
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