Anyone who has taken a look at the recent research review Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer should say a prayer that the EBM thought police do not get control over the practice of medicine in America under the banner of cost containment OR conflict of interest. The "guidelines", if you can call them that, are drivel, essentially conceding two points: First, that patient and tumor characateristics heavily influence treatment selections and do so over the course of disease. Second -- and by extension -- that clinical expertise matters. But of course many oncologist with the best expertise fail the holier than thou COI standard imposed by those who hide their agenda under the purity banner (the capitalism=corruption=corrupt medicine coalition). As the panels to decide what is best practice are picked, you can be sure that their will be tribunals, inquests, witchhunts and general suppression of the ability of any one who consults with pharma or biotech companies, anyone who has a research contract or runs a clinical trial for a drug company will be purged of participation. This is nothing short than an attack on intellectual freedom as harsh and as unrelenting as anything seen in the sciences or liberal arts in recent years. And this is not a matter of forcing college kids to do research on reasons why Bush should be impeached. This boils down to a bunch of autocrats trying to dictate to the rest of us a politically correct form of medicine....
For a taste of force-fed medicine to come:
http://effectivehealthcare.ahrq.gov/healthInfo.cfm?infotype=rr&ProcessID=9&DocID=79
For a taste of force-fed medicine to come:
http://effectivehealthcare.ahrq.gov/healthInfo.cfm?infotype=rr&ProcessID=9&DocID=79