Most healthcare interventions are not highly effective, per the Cochrane Report peer review
A few months back, I made a few posts about Rockefeller healthcare, the pay for play pharma regime, and evidence based practice. I discussed the woes of evidence based practice as journals and research that guide our “best practice” guidelines…..but the data IN them is oftentimes paid for and sponsored by pharma, millions of dollars funneled through prestigious universities to publish what pharma paid them to publish, so they can put anything into scientific journals that they want to. Is evidence based practice really the “best” practice? In the name of “science” we set up a hierarchy of what creates “good medical evidence” which is peer reviewed randomized controlled trials that are replicated with same findings. I now question if that is even truth……because if the regime that is running and funding the trials and research and data are manipulating the data, it isn’t even credible. I used the damn Cochrane search database for research during my masters AND my doctorate, as they were considered some of the HIGHEST levels of research and gold standard practice out there. Healthcare has been trained to use what Cochrane puts out as standards of practice! The NEJM is not much better. It is sickening at a very visceral level for those of us who use these standards of practice, who want to do good for our patients.
Here is a follow up. Dr. Alexander discussed a published journal article about the efficacy of healthcare interventions.
Here is the journal article he is discussing:
https://www.sciencedirect.com/science/article/abs/pii/S0895435622001007
Here are the highlight findings FROM the study:
In this large sample of 1,567 interventions studied within Cochrane reviews, effects of most interventions (94%) interventions were not supported by high-quality evidence.
Potential harms of healthcare interventions were measured more than benefits.
Patients, doctors, and policy makers should consider the lack of high-quality evidence supporting the benefits and harms of many interventions in their decision-making.
There was sampling of interventions done from 2008-2021. So 13 years of interventions they looked at. They examined COCHRANE reviews for interventions. Why is this important? Well, because COCHRANE has been determined to be one of the almighty powerful beings that guide evidence based practice and healthcare decision making. COCHRANE is considered one of the most trusted experts, their guidelines are used as gold-standards for care, and historically if you followed THEIR guidelines and found yourself in a malpractice situation, evidence that you USED their guidelines meant you gave exemplary care and the patient just had a negative outcome “regardless” not “because of”.
Here are the findings and conclusions:
Of 1,567 eligible interventions, 87 (5.6%) had high-quality evidence supporting their benefits. Harms were measured for 577 (36.8%) interventions. There was statistically significant evidence for harm in 127 (8.1%) of these. More than 9 in 10 healthcare interventions studied within recent Cochrane Reviews are not supported by high-quality evidence, and harms are under-reported.
WOW. Lack of high quality evidence to support interventions? Underreported harms? From one of the GOLD STANDARD entities to guide healthcare??? Now back up here a minute……haven’t we denied any “right to try” treatments during covid because they “allegedly” lacked “high quality evidence” to support them? Yet we are quite ok performing daily medical procedures based on the same lack of high quality evidence?
Who owns Cochrane Review? That is impossible to find because it is not one entity. They are a private company. They claim to be a non-profit out of the UK. But, per their reporting, they they are GOVERNMENT and PRIVATELY funded. National and international government and non-government funding, hospitals, universities, private foundations, and PERSONAL donations world-wide. Included in the funding lists from 2019 includes: NIH, the UK Government, the Danish Government, Germany Federal Ministry of Health, The Cochrane Charity, the WHO, University of Copenhagen, American Academy of Pediatrics, Oxford, Wiley Publishing (AN EDUCATIONAL TEXTBOOK PUBLISHING COMPANY) that is a publicly traded company on the NYSE. HMMM, I wonder why a textbook publishing company would be an investor in a company that sets forth healthcare intervention recommendations? Think there is any sway and manipulation going on there?
A further dig on the Wiley textbook company…….they proudly tout that they publish the yearly JCR, or Cochrane Review, which they proclaim is “one of the most widely used citation metrics of peer reviewed journals”. Well. I am not sure you want to admit that after this data came out about the poor quality and outcomes FROM their data and interventions! Wiley also publishes the Cochrane Library, which is ALL compilations of evidence based practice journals and medical intervention manuals. Is Cochrane REALLY a charity non profit? No. A for-profit disseminates all of their work. Most of Wiley’s yearly profits COME FROM their publications of the Cochrane documents, libraries, and journals! It is a pretty safe hypothesis to say Wiley and Cochrane are in bed together, paying each other, to disseminate whatever they decide they want to. And healthcare professionals eat it up as credible and good data.
It is a sad reality when healthcare has to swallow the bitter pill that nearly everything we have been taught is potentially propaganda for a company who wants to make money. As I said in my earlier post about this, are we TRULY doing what is best for patients? Or are we following guidelines that are made to make someone rich?
If you are in healthcare and using Cochrane as your primary research source for evidence based practice, I think I would stop and diversify my data culling.