Tuesday, 16 October 2012

Collecting anecdotes

Science should be more community based and more community-oriented, and that this in turn leads to financial savings (very important given the current preoccupation with austerity measures across Europe and North America). For example Cassel and Brennan (2007) argued that the [US] health system would be better off if doctors took part in a medical commons together with patients, and that this would improve the allocation of health care resources.
Munro (2005) wrote that clinicians believe that clinical practice must be evidence based and that randomized controlled trials and secondarily systematic reviews provide the best evidence upon which to base medical practice. In this world-view however, observational studies and accounts of accumulated clinical experience are not considered meritorious or interesting, and so, according to the conventional wisdom, they are not published. Munro then makes a case that observational studies have merit especially for personalized medicine and that better standards for them should be designed. Aronson (2003) points out that anecdotes are frequently published in compilations of the side effects of drugs and provide information of the potential adverse reactions or interactions, mechanisms, diagnostic techniques, or methods of management; anecdotes can generate or test hypotheses, and remind or educate; and, like trials, they can be subjected to systematic review, but of a different kind.

Aronson, J.k. 2003. Anecdotes as evidence. We need guidelines for reporting anecdotes of suspected adverse drug reactions. BMJ 326:1346.
Cassel, Christine K., Brennan, Troyen E. 2007. Managing Medical Resources. Return to the Commons? JAMA 297 (22): 2518-2520.
Munro, A.J. 2005. Commentary. The conventional wisdom and the activities of the middle range. The British Journal of Radiology, 78 (2005), 381–383.