When Evidence Says ‘No,’ but Doctors Say Yes

March 7, 2018
Karen O’Malia

Description: Years after research contradicts common practices, patients continue to demand them and doctors continue to deliver. The result is an epidemic of unnecessary and unhelpful treatment.” (Based upon an article by David Epstein, co-published by ProPublica and The Atlantic on February 22, 2017.)

From stents and open-heart surgery to medications, many common treatments have been shown to be ineffective, and sometimes harmful. Yet physicians and surgeons continue to prescribe drugs and perform procedures and surgeries long after they have been shown to be ineffective. Why? Because common “knowledge” dies hard, and because profit remains a strong motivation.

Effectiveness is clouded by poor research and experiments designed to overstate positive outcomes. “Relative risk is just another way of lying,” implying that the treatment is far more effective that it really is.

A more reliable way of reporting outcomes of medication and surgery is NNT, number needed to treat, and NNH, number needed to harm. Both are measures of how many people need treatment to get one positive outcome, and, conversely, how many of those treated will experience a negative outcome. For the article used in the preparation of this talk, please click here.

Karen O’Malia’s Bio: karen became interested in biology in high school; majored in French, and studied Spanish, art history, and biology as an undergrad; did graduate work in biology, with a concentration in ecology; went back to grad school later for a Master’s in counseling. Continued to read on topics in biology, bio and organic chemistry, and medicine. Her three careers include teaching high school French, corporate financial sales and management, and legal pharmaceutical product liability case management.