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What is the Clinical Medicine evidence base?

Regarding Clinical Medicine (and in particular Mental Health interventions): Increasingly we have been “encouraged” to place our faith in NICE guidelines and evidence based medicine, but we have had the recent news that the drugs don’t work. My question is: what is the evidence base for the evidence base.
Sam Gothard from Greater London (Age 35-44)


One Response

  1. All the drugs that are released into the global market have to undergo testing phases.
    They test numerous things including how the drug is absorbed into the body, excreted from the body and the appropriate dose required to provide the desired affect.
    The evidence base that you refer to is based on Statistics. These statistics say that in order for you to state that the drug is effective you have to show that the difference between the placebo (or current treatment) and your treatment is clinically relevant (worth the money to produce it).
    We then use statistical formula based on this clinically relevant difference, the power required (1- beta where beta is known as a Type II error), the significance level (known as a Type I error) and the expected variance between the subjects to calculate how many patients are need to show this result.
    We can then test our Null Hypothesis: that there is no difference between the treatments against the Alternative Hypothesis: that there is a clinically relevant difference between the treatments.
    As a note, a type I error is the probability of rejecting the null hypothesis when it is true, typically set to 5%. A type II error is the probability of failing to reject the null hypothesis when the alternative is true.

    We then conduct the test and if the difference between the treatments is significant then the drug is said to have evidence of its effectiveness. That is that it would be unusual to see the difference observed if the treatments had the same effect.

    In essence the evidence base is statistics.

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