It is a truth universally acknowledged that a medical intervention justified by observational data must be in want of verification through a randomised controlled trial.
A meta-analysis raises some doubts.
More research is needed. In the meantime, shouldn’t we stop spending millions of taxpayer dollars on a technology without a scrap of real evidence to support it?
Author: Mark Kleiman
Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out.
Books:
Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken)
When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist
Against Excess: Drug Policy for Results (Basic, 1993)
Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989)
UCLA Homepage
Curriculum Vitae
Contact: Markarkleiman-at-gmail.com
View all posts by Mark Kleiman
It's *so* doubtful that the Page Cannot Be Found. That is truly an area for more research.
Sarah's right, the Page Which Cannot Be Found can be found but only through an old Jedi trick: Use The Source. This blog entry suffers from some malformed HTML. (Gotta love that blogging software, eh?) The proper link URL is:
http://WWW.samefacts.com/archives/RCT_Parachute%5…
It's an article from the British Medical Journal in 2003.
That article clearly proves that empirical evidence is not important, and that we should just trust the "obvious" answer on most questions.
Url problem fixed now.
Why would anyone want to jump out of a perfectly good airplane?
April 1 came and went quite a while ago.
Funny but as an attack on evidence-based medicine a bit demagogic in my view.
Rilkefan:
It's hardly an attack on evidence-based medicine. It's an attack on people with an excessively limited notion of what ought to count as evidence. Just because a phenomenon can't be demonsrated in a randomized controlled trial doesn't mean it's imaginary, or that using it represents "belief-based" rather than "evidence-based" practice.
Mark Kleiman wrote:
"Just because a phenomenon can't be demonsrated in a randomized controlled trial doesn't mean it's imaginary, or that using it represents "belief-based" rather than "evidence-based" practice."
Hilarious, well amusing, paper.
I've often wondered whether physicians would stop believing in the laws of physics if they ever realized how they were made, ie: without randomized double blind trials.
On second thought, maybe their longstanding status as leaders in private pilot aircrash statistics indicates that they really don't believe the laws of physics.
"It's hardly an attack on evidence-based medicine."
It certainly seemed that way to me from their calling ebm out at the start.
Maybe being a physicist gives me an odd perspective, but I think there are few people out there needing to rely less on data and more on what everybody thinks is obviously true.
I believe that the only solution to this problem is to conduct the trial. I even have a few good control subjects in mind.