E-patient Dave (Dave deBronkart, diagnosed two years ago with stage 4 kidney cancer), blogs today under the headline, “e-Patients and doctors both, wise up. If you haven’t already.” If you don’t know about Dave, you should. He’s one of the hottest speakers at health care meetings these days. He begins today’s blog:
“I’ve only been studying healthcare for two years – far less than most people on this blog – and I hesitate to be overly assertive. But I have, finally, reached the point where I feel confident in citing cases where people are simply being unscientific: ignoring evidence. That’s always hazardous, and it becomes insidious when it’s caused by a blind, unquestioning belief in our institutions.”
One of those institutions, he points out, is the peer-review system. He quotes Richard Smith, longtime editor of the British Medical Journal, who wrote in the Journal of Participatory Medicine:
“…evidence on the upside of peer review is sparse, while evidence on the downside is abundant. We struggle to find convincing evidence of its benefit, but we know that it is slow, expensive, largely a lottery, poor at detecting error, ineffective at diagnosing fraud, biased, and prone to abuse. Sadly we also know–from hundreds of systematic reviews of different subjects and from studies of the methodological and statistical standards of published papers–that most of what appears in peer-reviewed journals is scientifically weak.”
Finally, Dave plugged our project, which he calls a “wise-up tool.”
Read his entire column. I’ve only given you a few points from it.