Systematic Review and Evidence-Based Medicine

You've probably heard of "evidence-based medicine". It's the idea that we practice based on research and data. There's another way of practicing called "eminence-based medicine". It's the idea that we listen to the person who's been around the longest or who has somehow managed to be labelled the expert.
It used to be that such a person would periodically get to write a review article in some journal, and that would be how everyone learned what to do in medicine. That's a problem. We've got a solution. Systematic reviews!


John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

[swill]

A three hour grad school lecture minus 2:55:00 of fluff, for free! Thanks Dr. Carrol!

[InorganicVegan]

Aaron, I have a list of ideas for topics you can discuss.
-Circumcision
-Vegetarianism/Veganism
-What to feed your dogs in terms of people food
Also, 60 seconds? I've never been this early.

[Zerkbern]

Thanks for the insight, Doc.  This is one of my favorite segments of yours so far, descriptive of the process, concise and illuminating. 

Thanks again.

[melaniemalacaraaguilera]

I love Healthcare Triage! amazing way to educate the general population! Thank you Aaron!!

[ShadowRevya]

Can you do an episode on self-diagnosis?

[atelat]

I think it is great that these videos also teach how to understand science and distinguish between good or bad studies. The concepts are applicable to some many other fields, and I find them quite helpful :)

[BabyBellaMarie]

Hi Dr Carrol :) In biology last term we wrote a response to a socio-scientific issue, which happened to be artificial water fluoridation. My end position was, unsurprisingly, that fluoride should be kept in my city's waterways. I read several systematic reviews which followed a structure just like the one you described, and it's pleasing to see my research was scientifically legitimate. 
In saying that, I would really appreciate a video about your opinion on water fluoridation, especially in the United States (as Americans tend to get more upset about these things than the good ol' Kiwis!) 

[Saravelda]

One of my favorite HCT segments to date. Loved hearing about your research!

[DanThePropMan]

Dr. Carroll, I'm very curious what you think about the AllTrials campaign. Granted, they seem to be focusing most of their efforts in Europe, but I'm glad the issue is getting attention.

[TheLiddynaturel]

You may be interested in this: Before leaving the hospital after giving birth 3 different Dr's came to my room to emphasize new studies on colic showed that babies are not born with the enzymes to break dairy down and do not develop them until after 6 weeks but the babies gut changes every 3 months and I was to cut all dairy out and test every 3 months to see if changes occurred. I also spoke with Dr. Jay Gordon (pediatrician and author) who emphasized only circular and pushing palm of my hand up in the upper left hand corner of my babies back instead of patting to burp. I followed all directions and my baby NEVER cried, NEVER spit up, NEVER had diaper rash. I was able to introduce dairy by 9 months without any reactions (previously he cried, a lot, when I tried). Very interesting. There should be a systematic review done using this model as a search.

[globemaster]

Thank you! I am about to start a systematic review for university, this has been a really helpful overview.

[thTuesday]

Your structure of a paper is really helpful for me writing my thesis.

[birddog]

Are there any evidence-based studies on the actual effects on the human body of second hand smoke?

[LetumComplexo]

So the answer to your baby throwing up about twice a day is to clean it up and not worry about it too much? But to always keep an eye one him/her in case it gets worse?

[natedawww]

I wish people understood better how to interpret study results, never mind systematic review. This is especially frustrating when it comes to the reporting of studies. It leads to a general mistrust because, from a public perspective, they will often hear this artificial back-and-forth about the potential merits or harms regarding a substance or treatment. When this happens often enough, a person is likely to just shrug their shoulders to the whole thing, which reinforces a general attitude of disdain for science and scientists.

[Doryuu]

How about an episode on the safety of bottled water versus tap water (including tap water in a variety of countries)?

[elleb.]

This video is very helpful . I enjoy listening to you speaks . I hope you have more videos.

[oddzag]

So all of these doctors were prescribing medication that didn't work? Based on what? If the system works as well as you say, why was a systematic review necessary to disprove something that had never been proved in the first place? Surely if there was no evidence to support this medication's use, it shouldn't have been used. Was it used simply because there was no evidence against it either?

[adamhetz]

So....how about antacids like ranitidine?

[saberepee]

Ypu really must have been a painfully brilliant Student. Love it.

Underestimating the "I need to calm down this obnoxious stressed-out Parent"