Dr. Harvey Risch: "Plausibility But Not Science Has Dominated Public Discussions of the Covid Pandemic"; excellent Brownstone piece & questioning of evidence-based medicine (EBM); I argue, EBM is dead

by Paul Alexander

EBM, medical journal publishing, academic research, medical research, clinical medical doctors...the reputations are now destroyed by COVID, by greedy, corrupted, biased people who harmed populations

Alan R:

"EBM, medical journal publishing, academic research, medical research, clinical medical doctors...the reputations are now destroyed..." and will never be revived, the entire edifice of the medical establishment is DOA, time of death the early 21st century (after a long illness than spans most of the 20th)”



‘Evidence-Based Medicine

There is perhaps no bigger plausibility sham today than “evidence-based medicine” (EBM). This term was coined by Gordon Guyatt in 1990, after his first attempt, “Scientific Medicine,” failed to gain acceptance the previous year. As a university epidemiologist in 1991, I was insulted by the hubris and ignorance in the use of this term, EBM, as if medical evidence were somehow “unscientific” until proclaimed a new discipline with new rules for evidence. I was not alone in criticism of EBM (Sackett et al., 1996), though much of that negative response seems to have been based on loss of narrative control rather than on objective review of what medical research had actually accomplished without “EBM.”

Western medical knowledge has accreted for thousands of years. In the Hebrew Bible (Exodus 21:19), “When two parties quarrel and one strikes the other … the victim shall be made thoroughly healed” [my translation] which implies that individuals who had types of medical knowledge existed and that some degree of efficacy inhered. Hippocrates, in the fifth-fourth century BCE, suggested that disease development might not be random but related to exposures from the environment or to certain behaviors. In that era, there were plenty of what today we would consider counterexamples to good medical practice. Nevertheless, it was a start, to think about rational evidence for medical knowledge.

James Lind (1716-1794) advocated for scurvy protection through the eating of citrus. This treatment was known to the ancients, and in particular had been earlier recommended by the English military surgeon John Woodall (1570-1643)—but Woodall was ignored. Lind gets the credit because in 1747 he carried out a small but successful nonrandomized, controlled trial of oranges and lemons vs other substances among 12 scurvy patients.

During the 1800s, Edward Jenner’s use of cowpox as a smallpox vaccine was elaborated by culturing in other animals and put into general use in outbreaks, so that by the time of the 1905 Supreme Court case of Jacobson v. Massachusetts, the Chief Justice could assert that smallpox vaccination was agreed upon by medical authorities to be a commonly accepted procedure. Medical journals started regular publications also in the 1800s. For example, the Lancet began publishing in 1824. Accreting medical knowledge started to be shared and debated more generally and widely.’…