Evidence: The problem of plenty

Over the past few years, there has been a tremendous increase in the number of scientific articles being published.

In addition, clinicians have become busier.

Teaching Hospitals are now catering to a much larger number of patients than ever before. This has been driven by systemic changes in healthcare provision and medical education/ training.

With the health insurance companies linking care to such institutions, many more people are seeking their expertise.

In a nutshell, medical training has taken a backseat to patient care in most teaching institutions. This has left doctors at all levels with little time for academic pursuits like reading journal articles.

According to a study, doctors who read regularly spend between 15-60 minutes on scientific reading each day.

The disturbing fact is that nearly 30% doctors do not read at all!

Another estimate indicates that a doctor would have to read 17 articles each day, 365 days a year to keep up with the current developments in his/ her field.

Since this is quite unlikely, what do doctors do to remain informed?

They listen to the medical representatives of various companies.

These representatives present scientific studies/ articles that promote drugs/products developed in-house by their respective pharmaceutical companies.

Needless to say, such articles/ studies carry a high risk of bias in favour of the product (since the drug company is sponsoring it all).

All this notwithstanding, the busy doctor has little choice but to accept whatever the representative says. Often, there is little time to pause and really make sense of the article/ study.

The other problem arises when a funding agency influences the government to promote something. There may be little evidence, but money talks, and when there is a lot of it, it drowns everyone else out.

In some countries there is the additional problem of drug advertisements. Unsuspecting individuals fall prey to misleading/ exaggerated claims of all kinds.

Finally, there is the media. A single news item is enough to spur masses of people into action, often on the basis of a single study.

Thus, we are living in an era of information explosion and overload. Sifting through all the evidence is not practical. We need to know how to make sense of and evaluate the evidence to make better decisions. We also need to know where to look for high quality evidence, so that we can save time and effort.

I will discuss these themes in subsequent posts.

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