Medical Advances Minus the Full Research Apparatus

American Thinker.com ^ | April 10, 2020 | Brian C.Joondeph, MD

[Kaslin]

Anecdotal evidence is based on a real-life event, perhaps just a single occurrence. In medicine and science, much current knowledge began with an anecdote. A famous example occurred in 1928, when Sir Alexander Fleming happened to observe that mold developed on an accidentally contaminated staphylococcus culture plate, and that the mold prevented growth of the bacteria.

This led to the discovery of penicillin, saving countless lives, based on anecdotal evidence of bacteria not growing near a spot of mold. With World War II creating injuries, infections, and sepsis, penicillin was produced in mass, preserving lives and limbs.

Another more recent example comes from my world of retina surgery. An anti-cancer drug, Avastin, was injected into the eyes of a few patients with advanced macular degeneration. These few patients responded well, anecdotally. After this breakthrough was reported at a retina meeting, it almost immediately became the new treatment standard worldwide.

There were no prospective, randomized clinical trials, considered the gold standard, just the anecdotal observation that this off label treatment worked and saved vision. Despite being the most commonly used treatment for macular degeneration, Avastin is still not FDA approved for this indication.

At the time of inception, the risks were unknown. Could it cause a stroke? Inflammation? Infection? This was a drug that didn’t go through the FDA approval process, at least for injection in the eye, despite it being FDA approved as chemotherapy for metastatic cancer.

[allendale]

The vast majority of advances in Medicine have come from ethical Edisonian empiricism. Good people making therapeutic efforts and then honestly noting what works and doesn’t work. the scientific explanations come later. The type of physicians who nest at the CDC and the FDA are not known for their daring empiricism. During this crisis you are far more likely to obtain good information an insight by interviewing and listening to the front line clinicians who are trying different modalities than if you attend seminars at the FDA,CDC or attend Dr. Fauci’s press conferences.

[FreedomPoster]

>> Has Trump derangement syndrome so afflicted the media and the left that their hostility toward hydroxy is based solely on the fact that President Trump promoted it?

Absolutely Yes!

I’m seeing it personally in a group I engage with online. The #TDS is off the charts.

[FreedomPoster]

And great article, thanks for posting.

[John Milner]

If I remember correctly the used of Nitrous Oxide for an anesthesia was basically accidental. The rich/elite were using it as an entertainment drug - laughing gas. A doctor observed one party attendee under the influence injured himself - and continued to laugh and ignore the pain.

The light bulb went off. Maybe this could be used for painful surgery to keep the patient still and calm.

[ClearCase_guy]

Note also that a lot of scientific studies (I admit I’m mostly thinking of psychology) get published and then years later people find that the results cannot be duplicated at all because the study was worthless.

Note that many medicines go through a full study, get FDA approval, get marketed on TV, and then get pulled because people find out that the medicine is dangerous and/or worthless.

Scientific studies are fine. I am not opposed. But Fauci’s idea that anecdotal information is not worthy of respect and that you really need a study in order to approve something — I think he’s not thinking outside the box at a time when he should be.

[norwaypinesavage]

I am an engineer, not a doctor. I have more than a half century of experience in my profession. As such, I take offence at the derogatory use of the word ‘anecdotal’ in describing evidence. Most engineering decisions are based on what can be be described as ‘anecdotal evidence’ in the medical community. Often times, decisions are made on the result of a single test observation. You simply don’t need a “double blind study” when results are consistent and repeatable.

I appreciate that doctors often make daily decisions that can affect the life or death of a patient, and that if they regularly second-guessed these decisions they might justifiably go insane. They must appreciate, though, that engineers make life or death decisions, too, as well, as do business leaders, restaurant owners, janitors, drivers, walkers, and housewives. The rest of us don’t have the privilege of demanding a ‘double blind survey’ to assuage our psyche. Anecdotal evidence is just fine. Just don’t prevent us from making our own life or death decisions. Remember, the greatest percentage increase in information comes when you go from zero results to one result.