Monday, September 25, 2006

A little smarts can smart

…Screenwriter William Goldman famously once said of Hollywood: “Nobody knows anything.”

…Writing in the NYT (Sept 16, 2006), Jerry Avorn says many of the people who give you medical advice or run over and try to minister to you might not know the right things to do, either.

…He cites his own experience, when he suffered a jellyfish sting and lifeguards and passers-by all gave him the wrong, water, vinegar.

….A nurse came along and calmly removed the stinger, dripping with neurotoxins.

…Turns out--funny story--the distilled water poured on at first actually activates those poisons.

…Avorn, a drug tester at Harvard, says his research group constantly comes across effective treatments that are underused and poor-choice drugs that are widely prescribed.

…There is no coherent system, he says, for getting the word out to doctors on which is which.

…So often some of them may look at the glitzy promotional items the drug detailers just left them and think, “Hmmm, CuresIt is worth a try.”

…We need more studies comparing two drugs against each other, instead of one drug for effectiveness and safety.

…Usually drug companies like to compare their drug against a placebo, because the drugs usually win that way.

…In Pennsylvania there is a pilot project called the Independent Drug Information Service (, where researchers scan the medical research for the best evidence on how to treat a condition.

…Similar programs also exist in Canada and Australia.

…A little knowledge may not always be a dangerous thing.

...But a lot of knowledge is better.

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