Clinical trials are research studies that aim to establish whether a medical strategy, treatment or device is safe for use or consumption by humans. These studies may also suggest which medical approaches prove most effective for specific conditions or groups of people. They advance medical knowledge. Clinical trials are the cornerstone of Western medicine. They provide the most reliable data to assist in healthcare decision-making.
Such trials start with small groups, initially, to examine whether a new method causes any harm or unsatisfactory side-effects. This ensures safety for participants. Often, a technique that is successful in a laboratory or on animals may not be a success in humans; animal studies may also prove dangerous when extrapolated to humans. But scientists, pharma companies and health professionals have immense faith in this evidence and so do many doctors who do not go deep into researching such ‘evidence-based’ approach.
If you go deep, you may find many flaws in the evidence. For one, the studies are very short-term and are cross-sectional. They very wrongly assume that one size fits all; while, in reality, no two human beings, even twins, are alike and can be compared. Long-term observational studies are much more reliable. The so-called double blinding is a trap. The interaction between the consciousness of the subject and the researcher is now well established. All these, and more, made Sir Michael Rawlins, the chief of National Institute of Health & Care Excellence (NICE), UK, say that randomised control trials have been wrongly given a high priority in medical research. In addition, the very short duration of these cross-sectional studies may lead to even the dangerous side-effects being unrecognised making adverse drug reactions a serious problem with Western medicine.
Western science has no other option to offer and long-term observational studies are too cumbersome and expensive to the pharma lobby. In addition, audits show that industry-funded studies come up 95% of the time with positive outcomes. When the same study is replicated with independent funding, the positive results decline to 15%. Most of the evidence gathered is funded by the industry. In addition, many of these reputed researchers have financial ties with the industry. So much for its authenticity! The further details of industry influence of our evidence gathering is available in this classic by the former editor of the prestigious New England Journal of Medicine, Dr Marcia Angell, The Truth about Drug Companies - How they deceive us and what to do about that.
In addition, the American guidelines committees further complicate the picture. The blood pressure guidelines are a good example. The guidelines recommend putting patients on medicine to control hypertension at a much lower blood pressure level (when no drugs should be used below 159/99). This allowed the industry to laugh all the way to their banks as it brought millions more people in their net to deal with their imaginary hypertension.
Diabetes, which has been now shown to be easily curable, was shown to be non-curable by the industry to sell drugs life-long! For making money, they peddle all lies in the medical field where death is only a statistic and human life is cheap. With this background, one could easily understand how the so-called proof of the effect of Western medicine can be relied on. The evidence can be easily manufactured at will.
Ayurveda is much more reliable, based on thousands of years of observational research. We should also remember the saying that absence of evidence in no evidence of absence. That apart, even if all the above-mentioned drawbacks could be rectified, we are still left with the main problem of not being able to club people together as cohorts for comparison. There is no better method other than longitudinal observational studies. But, recently, there even was a suggestion to pool anecdotal experiences together to avoid expensive time-consuming longitudinal studies!
But that is not for lack of research or evidence in the western (esp. US) societies, the evidence has been neglected, suppressed or laughed at by the established money minting industries, including media.
But there are many enlightened MDs and RDs and surgeons who have been practising the "Food be thy medicine" policy for a long time. eg. Dr. John McDougall, Prof. Caldwell Esselstyn, Dr. Garth Davis, Brian Clement, Dr. Michael Greger, Dr Joel Furhman, Dr. Neal Barnard of PCRM and many more.
Watching these men (on youtube) speak of the disease and food/living connection is enlightening and a must for anyone interested in healthy life
Evidence based medicine depends a lot on how the study is structured and on the underlying principles. For instance, let's say there is a guy in a village who starts beating a drum every time there is an earthquake and it's only because of his drum beating, does the earthquake come to a halt. One can SCIENTIFICALLY prove that there is a 100% correlation between his drum beating and the earthquake i.e. Pearson's correlation coefficient r =1 !But we all understand that this is not the correct likely explanations.
While a do agree with Dr. Hegde that cohort studies are way better than cross sectional studies and the drug companies do tend to extrapolate the observations made on only a few subjects to the entire population, I would like to point out that the ONLY other way to be absolutely sure that a drug is not only effective but also pick up rare side effects - is to give it to the ENTIRE population of the planet and then study them.
The whole point of conducting trials is that we cannot possibly study the entire population so we just take a representative sample and then extrapolate the results based on statistical methods.
Once a drug completes Phase 1, 2 and 3 trials, it enters the post-marketing surveillance a.k.a Phase 4 trials. The entire point of this phase 4 is to pick up RARE side effects. The author probably suffers from a base rate bias. For instance, there is misconception that Oral Polio vaccine is not safe as it may rarely case a VAPP(Vaccine associated Paralytic Polio), but the probability of this happening ranges from 1 in 7 lakh to 1 in 60 lakh (http://www.who.int/vaccine_safety/initiative/tools/polio_vaccine_rates_information_sheet.pdf).
To compare, the odds of a person in the UK to be involved in a fatal pedestrian accident is 1 in 647!!
By the author's logic, one should stop going out at all and stay cramped in one's house our entire lives!!
The author has also pointed out that the recent JNC8 guidelines which have changed the Blood Pressure guidelines, is just a farcical move by thedrug companies to exhort more revenue. While I do not have sufficient evidence to support it, I would like to quote Adam Smith in this matter -
"It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest."
And while the author has written with impunity that NO DRUG is recommended for BP below 159/99, I would like to ask him one question - from where on Earth did he get THIS figure, if not from past editions of JNC recommendations? And if the pharma companies have the ability to affect the JNC recommendations now, why coudn't they have done the same earlier as well? Perhaps all this hoopla around the need to even check blood pressure is just a plot by the companies making the BP measuring instruments? What evidence does the author give to suggest that there is even a need to check BP, if not from the evidence posted in clinical trials? Why treat Blood pressure at all?
The author also states that Diabetes is "easily curable". While I do agree that it can be managed without the need for drugs - if you are obese, just lose like 10%-15% of your body weight and voila! I would like to point out that the author has mistaken the EASE of doing something with the SIMPLICITY of doing it. For example, losing weight is SIMPLE - just eat less and work out more, but is it really EASY? Similarly, becoming rich is SIMPLE - just consistently spend less than you earn and invest the difference, but its not all that easy!
I would like to hear from the author regarding this "easy" method of curing diabetes. Given the amount of disdain the author has for the pharma companies, why doesn't he come out with this "easy" cure and help millions of people and run the pharma companies to the ground.
In my opinion, people flock to Ayurveda because it offers "easy" solutions. No Ayurveda doctor is going to look at one's HbA1c or Kidney function tests- naah, they are just too much of a hassle. Just pop this sugar coated ayurveda pill and you will be "easily cured". On the other hand, if one goes to a "western" doctor, he will order a battery of tests before even prescribing a drug(some drugs like Metformin cannot be given to kidney patients). He will say things like "you have to get more exercise" or "reduce weight". These things are hard pills to digest and require one to make tough choices.
The author has also implied that ayurveda is more reliable because it has "thousands of years of observational research". Perhaps what the author is referring to is the Lindy effect. The Lindy effect is a concept that the future life expectancy of some non-perishable things like a technology or an idea is proportional to their current age, so that every additional period of survival implies a longer remaining life expectancy.
However, it does have it's limitations- if we follow the same advise that just because some idea or something has persisted for thousands of years, we should not really be eradicating things like caste system, child marriage, sati, untouchability etc.
Just because Ayurveda has persisted for several years does not validate the idea. The Geocentric theory of the universe i.e. Earth is the centre of the universe, had persisted for hundreds of years before Copernicus. The church's efforts to discredit him and Galileo could be compared to the authors efforts to discredit modern science.
The author talks about evidence - but what about the evidence that herbal/ayurvedic preparations have caused damage as well? Many of the so called "Herbal formulations" contain toxic heavy metals and what not. (https://www.sciencedirect.com/science/article/pii/S0165614700019726,
https://www.amjmed.com/article/S0002-9343(97)00397-5/fulltext)
While I do agree that absence of evidence is not the same as evidence of absence, the author has given no evidence in support of ayurveda while at the same time has attempted to discredit the scientific medicine. Doesn't that seem hypocriticial?