Recent article suggests there is no evidence basis for giving oxygen to heart attack patients. So we should wait until there is, and deny patients access? -Not likely
This, however, happens all the time in Pain issues and is blatantly unethical.
Evid Based Med. 2010 Sep 22. [Epub ahead of print]
No current evidence that routine administration of oxygen to people with acute myocardial infarction improves pain or mortality; further conclusive trials are needed.
Mewton N, Yoneyama K.
Evidence based practice will deny access to useful medications and procedures until the evidence is so well documented they can’t deny it. In the meantime patients are left to suffer. Some procedures will not be done double blind because it is obviously unethical to restrict access to the subject (as would restricting Oxygen to heart attack victims). Example is tarsal tunnel syndrome in Diabetics – lots of studies showing good results but discounted – but will never ethically undergo controlled trials.
see Surgery For Diabetic Peripheral Neuropathy – Another Option Not Available Here
Drug access to certain pain medications is denied because only certain subgroups may respond – without the thought that only responders would be kept on drug anyway.
I hate evidence based medicine…
Any comments?