tag:blogger.com,1999:blog-4968787219619380438.post943464370245661097..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Discrediting the paper about discredited practicesSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-4968787219619380438.post-10886127170143088872013-08-30T13:26:59.930-04:002013-08-30T13:26:59.930-04:00Anon, I am not sure that laparoscopic hernia repai...Anon, I am not sure that laparoscopic hernia repair is better. It might not be. The point is that the NEJM paper saying it was worse was flawed and has not deter surgeons from performing laparoscopic hernia repairs.<br /><br />Peter,<br /><br />I had seen the Ioannidis editorial. I'm a big fan of his. In the interest of space, I did not include his comments. <br /><br />I agree that surgery often does not have Grade I evidence to support a lot of what we do. That type of evidence is much harder to acquire in surgery. Again, my point in writing this post was that a single paper rarely changes practice and some of the 146 "discredited" practices were not really discredited by a single paper in NEJM.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-35492401792646704642013-08-29T23:03:49.265-04:002013-08-29T23:03:49.265-04:00In your eagerness to discredit Prasad et al, you m...In your eagerness to discredit Prasad et al, you missed a perceptive editorial in the same issue by Ioannidis, who pointed out several difficulties with the methods used. However, he repeated the assertion that in all areas of clinical medicine, primary care, dermatology and surgery more frequently lack evidence to support their treatments when compared with the current standard of internal medicine interventions. Peter Nigoshttps://www.blogger.com/profile/00240454577551517757noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-1651434683322190622013-08-29T22:39:52.740-04:002013-08-29T22:39:52.740-04:00It takes more than just one study to refute common...It takes more than just one study to refute common practice. On the other hand, multiple studies have legitimately taken down Swan-Ganz's and routine HRT, and saved lives doing so.<br /><br />Is laporospic inguinal hernia repair worse than open repair? Probably not. Is it better (in the sense of long-term outcome, pain, out-the-door time)? <br /><br />A big problem with studies involving procedural interventions is that *every* proceduralist considers himself above average, and thus the study results do not apply to him. "So there is no advantage shown, but in my hands, because I used 3 inches instead of 2.6....."<br /><br /><br /><br /><br />Anonymousnoreply@blogger.com