[e-drug] Wording of Papers, Use of Statistics (3)

["Klara Tisocki" <ktisocki@yahoo.ie>]

E-DRUG: Wording of Papers, Use of Statistics (3)
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Dear George,

A comment on your view on <evidence alone, without
professional, technical logic is more dangerous than
the lack of it>

I dont think that evidence alone or the lack of it is
anyway dangerous rather what we do or not do with it,
or do in the absence of it. 

History has shown us that having the necessary skill,
technology and knowledge and NOT using the evidence
can indeed be harmful. 

Some example to illustrate this point: 

1.	Consider the number  of patient with heart attacks 
in the last two decades who died prematurely because
they had never been offered antiplatelet therapy with
low dose aspirin, though strong evidence existed for
its prophylactic use by 1980.

2.	or the number of women with breast cancer, being
maimed and suffered greatly due to drastic breast
removal surgery that did not prolong their life
(though evidence showed  many years ago that this type
of surgery is not saving extra lives, only add more
suffering). 

Also think of the many thousands of patients with
HIV/TB in Africa who has not been receiving
cotrimoxazole prophylaxis for the last 5 years,
although we had the evidence from the Cote d'Ivoire
study (Anglaret, 1999), that it can significantly
reduce death and illness, even in a developing
country settings (not always optimal professional
skills, technical capacity or logistics) 

For many of these patient NOT using the evidence even
when only imperfect skills and logistics are available
has been far more dangerous than  evidence alone,
without professional, technical logic .

Klara

Dr Klara Tisocki
B. Pharm., M.Sc., Ph.D.
Phone: + 965 7975493
Fax: +1 775 4169388
Kuwait City
ktisocki@yahoo.ie