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Is evidence-based medicine misleading?

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Do we have all the information when it comes to basing a clinical decision on evidence based medicine?  I would like to think so but it doesn’t appear that way.

When I am searching for research papers in order to make a clinical decision such as the use of a new drug compared to existing drug therapy, I would like to think that I have all the correct information available to me.  However, there is no need for researchers to publish the trials which found that brand spanking new drug X doesn’t work as well as the competitor.  So when I am looking for evidence to tell my boss, a patient, another pharmacist or a prescriber about the evidence behind using new drug X, the majority of trials I will see are backing up the use of it.  But what about all those tests that showed the drug was not as effective, or had side effects limiting its use.  Those trials showing that a drug or regimen were not as successful are very rarely published.  But surely we need this negative data as well as the positive to make an informed decision, it is impossible to make an educated decision on only half, or sometimes less, of the available data.

In addition to this, we are unable to obtain figures for those trials that were conducted and were never sent to be published.  So are we even further from the truth?

I think it is very difficult to research a topic and be completely confident in the results that you find.  Keep in mind about the negative results as well as the positive.....

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