Evidence-Based Eddy Makes News Again

An article on evidence-based medicine in Newsweek makes EBM sound alternative and unorthodox--which indeed it was when first controversial proposed.

"With a groundbreaking computer simulation, Eddy showed that the conventional approach to treating diabetes did little to prevent the heart attacks and strokes that are complications of the disease. In contrast, a simple regimen of aspirin and generic drugs to lower blood pressure and cholesterol sent the rate of such incidents plunging. The payoff: healthier lives and hundreds of millions in savings." http://www.businessweek.com/magazine/content/06_22/b3986001.htm

The article quotes Dr. David Eddy as stating: "The problem is that we don't know what we are doing." The article continues: "Even today, with a high-tech health-care system that costs the nation $2 trillion a year, there is little or no evidence that many widely used treatments and procedures actually work better than various cheaper alternatives."

Dr. Eddy's zeal to show the truth, together with his aptitude for mathematics, helped him develop principles of EBM.

The article goes on to state that Eddy was "Dproving that the practice of medicine is more guesswork than science," and "repeatedly punctured cherished physician myths. He showed, for instance, that the annual chest X-ray was worthless, over the objections of doctors who made money off the regular visit. He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice -- preventing women from giving birth vaginally if they had previously had a cesarean -- to the recommendation of one lone doctor. Indeed, when he began taking on medicine's sacred cows, Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence."

Today, EBM is accepted as medical orthodoxy, but in the pioneering days of Dr. Eddy's questioning, he took on "medicine's sacred cows." The piece concludes that although preventive medicine and early testing can save lives, and effective medicine is black and white, "much of the rest of medicine is a dark shade of gray." That makes EBM a new "rallying cry."