JMERC
Owner
Janbazan Medical and Engineering Research Center (JMERC) is the owner of IJWPH.
0.3
Cite Score
SJR: 0.114 / SNIP: 0.090
Volume 14, Issue 3 (2022)
Iran J War Public Health 2022, 14(3): 359-360 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2022/07/23 | Accepted: 2022/09/4 | Published: 2022/10/12
Received: 2022/07/23 | Accepted: 2022/09/4 | Published: 2022/10/12
How to cite this article
Jahangir A. The Illusion of Evidence-Based Medicine. Iran J War Public Health 2022; 14 (3) : 100
URL: http://ijwph.ir/article-1-1220-en.html
URL: http://ijwph.ir/article-1-1220-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Authors
A. Jahangir *
School of Nursing and Midwifery, Army University of Medical Sciences, Tehran, Iran
Full-Text (HTML) (177 Views)
The main question is what happens when a drug is reported to be effective in an approved clinical study, but it turns out to be less effective or gives rise to side effects. We believe there should be other factors besides what the authors claimed correctly.
From one side there is a firm relationship between financial payments from industry with increased prescribing. Personal payment has a negative impact on the ability of physicians for independent therapeutic decision making with higher rate of harmful impacts on patients [1]. This could lead to the controversial evidence on the benefits and disadvantages after approving the drugs.
Furthermore, there is “intention” effect; the connection of the researchers will and patients’ recovery, a valuable therapeutic impact, regardless of any prescribed medications or treatments, with unclear mechanisms. The “observer” effect also relate to change situation/phenomenon only by observing [2]. Mind is a factor of causal power in healing within and between humans [3] and medical schools put emphasis on the value of intention: deciding in advance the goals they wish to attain [4].
How will/thought penetrate beyond the matter? Bohm, implied that despite the apparent solidity, the Universe is a gigantic and splendidly detailed hologram. Under certain circumstances, subatomic particles such as electrons are able to instantaneously communicate with each other, regardless of the distance separating them (1 feet or 10 billion miles apart). Somehow, each particle always seems to know what the other is doing. Bohm believes this separateness is an illusion and subatomic particles can remain in contact with one another and sending some sort of mysterious signal back-and-forth. He argues that at some deeper level of reality, such particles are not individual entities, but are actually extensions of the same fundamental being. According to Bohm, the connection among subatomic particles express that there is a profounder level of reality we are not privy to a more complex dimension beyond our own. He adds, since we see only a portion, we view objects as separate from one another. Particles are facets of a deeper and more underlying unity that is ultimately as holographic and indivisible (all of Nature is ultimately a seamless web [5]) Bohm is not the only researcher who has found evidence that the universe is a hologram. Stanford neurophysiologist Karl Pribram come up with a mechanism that might explain this curious "whole in every part" nature of memory storage (brain itself is a hologram). It is obviously much easier to understand how information can travel from the mind of individual 'A' to that of individual 'B', and helps to understand unsolved puzzles in psychology [2, 6]. This could explain the connection of researchers’ mind and patient’s body mind. This happen when the researches deeply believe that their medicine in trials are effective, and the patients receive the message, the connection at subatomic level deliver the message and the process of healing starts. But when the medications come to mass production, this will stop because the interconnection of physician-patient fades away. This might explain why some effective medications turn to ineffective or even harmful.
Thus, “intention/observer” effect bias of the researcher on the participants need to be considered in interpretation. Future studies could determine the effect of the researcher intention (the person who believes that a drug has an effect) by conducting simultaneous studies with those researchers who firmly believe that the drug/intervention is ineffective. This highlights the need for clinical trials based on the researcher's intents and wishes, which will help to determine whether medication effects are influenced by this phenomenon or not.
From one side there is a firm relationship between financial payments from industry with increased prescribing. Personal payment has a negative impact on the ability of physicians for independent therapeutic decision making with higher rate of harmful impacts on patients [1]. This could lead to the controversial evidence on the benefits and disadvantages after approving the drugs.
Furthermore, there is “intention” effect; the connection of the researchers will and patients’ recovery, a valuable therapeutic impact, regardless of any prescribed medications or treatments, with unclear mechanisms. The “observer” effect also relate to change situation/phenomenon only by observing [2]. Mind is a factor of causal power in healing within and between humans [3] and medical schools put emphasis on the value of intention: deciding in advance the goals they wish to attain [4].
How will/thought penetrate beyond the matter? Bohm, implied that despite the apparent solidity, the Universe is a gigantic and splendidly detailed hologram. Under certain circumstances, subatomic particles such as electrons are able to instantaneously communicate with each other, regardless of the distance separating them (1 feet or 10 billion miles apart). Somehow, each particle always seems to know what the other is doing. Bohm believes this separateness is an illusion and subatomic particles can remain in contact with one another and sending some sort of mysterious signal back-and-forth. He argues that at some deeper level of reality, such particles are not individual entities, but are actually extensions of the same fundamental being. According to Bohm, the connection among subatomic particles express that there is a profounder level of reality we are not privy to a more complex dimension beyond our own. He adds, since we see only a portion, we view objects as separate from one another. Particles are facets of a deeper and more underlying unity that is ultimately as holographic and indivisible (all of Nature is ultimately a seamless web [5]) Bohm is not the only researcher who has found evidence that the universe is a hologram. Stanford neurophysiologist Karl Pribram come up with a mechanism that might explain this curious "whole in every part" nature of memory storage (brain itself is a hologram). It is obviously much easier to understand how information can travel from the mind of individual 'A' to that of individual 'B', and helps to understand unsolved puzzles in psychology [2, 6]. This could explain the connection of researchers’ mind and patient’s body mind. This happen when the researches deeply believe that their medicine in trials are effective, and the patients receive the message, the connection at subatomic level deliver the message and the process of healing starts. But when the medications come to mass production, this will stop because the interconnection of physician-patient fades away. This might explain why some effective medications turn to ineffective or even harmful.
Thus, “intention/observer” effect bias of the researcher on the participants need to be considered in interpretation. Future studies could determine the effect of the researcher intention (the person who believes that a drug has an effect) by conducting simultaneous studies with those researchers who firmly believe that the drug/intervention is ineffective. This highlights the need for clinical trials based on the researcher's intents and wishes, which will help to determine whether medication effects are influenced by this phenomenon or not.
Keywords:
References
1. Mitchell AP, Trivedi NU, Gennarelli RL, Chimonas S, Tabatabai SM, Goldberg J, et al. Are financial payments from the pharmaceutical industry associated with physician prescribing? a systematic review. Ann Intern Med. 2021;174(3):353-61. [Link] [DOI:10.7326/M20-5665]
2. Baclawski K. The observer effect. 2018 IEEE Conference on Cognitive and Computational Aspects of Situation Management (CogSIMA). Boston: IEEE (Institute of Electrical and Electronics Engineers); 2018. pp. 83-9. [Link] [DOI:10.1109/COGSIMA.2018.8423983]
3. Di Blasi Z, E Harkness, E Ernst, A Georgiou, J Kleijnen. Influence of context effects on health outcomes: A systematic review. Lancet. 2001;357(9258):757-62. [Link] [DOI:10.1016/S0140-6736(00)04169-6]
4. Balboni MJ, Sullivan A, Amobi A, Phelps AC, Gorman DP, Zollfrank A, et al. Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. J Clin Oncol. 2013:31(4):461-7. [Link] [DOI:10.1200/JCO.2012.44.6443]
5. Bohm D, Peat FD. Science, order and creativity [Chapter 7]. 1st Edition. London: Routledge; 2010. [Link] [DOI:10.4324/9780203844816]
6. Pribram KH. Consciousness reassessed. Mind Matter. 2004;2(1):7-35. [Link]