Sleep apnoea and the misuse of evidence-based medicine

Abstract

There must be a middle way between the rigidity of randomised control trials as the only reliable evidence of efficacy and assessments, such as those of Stradling (Jan 18, p 201).1Stradling J Sleep apnoea and the misuse of evidence-based medicine.Lancet. 1997; 349: 201-202Summary Full Text Full Text PDF PubMed Scopus (32) Google Scholar His main argument seems to be that if sleep continuous positiveairway pressure were not effective it would not be tolerated; surely the knowledge that for decades the medical profession inflicted purging, cupping, and bleeding with no evidence of efficacy should warn us against such claims. Purchasers have a difficult middle path to tread between therapeutic nihilism and some extreme medical claims. The lesson here is for collaborative work, not least in the production of outcome-related contracts that should show the effectiveness of purchased treatment rather than finished consultant-episode-based contracts, which represent nothing other than workload. There must be a middle way between the rigidity of randomised control trials as the only reliable evidence of efficacy and assessments, such as those of Stradling (Jan 18, p 201).1Stradling J Sleep apnoea and the misuse of evidence-based medicine.Lancet. 1997; 349: 201-202Summary Full Text Full Text PDF PubMed Scopus (32) Google Scholar His main argument seems to be that if sleep continuous positiveairway pressure were not effective it would not be tolerated; surely the knowledge that for decades the medical profession inflicted purging, cupping, and bleeding with no evidence of efficacy should warn us against such claims. Purchasers have a difficult middle path to tread between therapeutic nihilism and some extreme medical claims. The lesson here is for collaborative work, not least in the production of outcome-related contracts that should show the effectiveness of purchased treatment rather than finished consultant-episode-based contracts, which represent nothing other than workload.