This page is a "blog" page. I will add a new summary of an interesting article every time I come across one.
These will be of a technical nature but hopefully still interesting to some.
It is human nature to want to be liked, respected and even revered.
Surgeons are no different. It is difficult for surgeons to differentiate themselves from each other without wearing "different clothes". These "clothes" are new technologies and new techniques that bring the promise of "better", "faster" and "less invasive".
Patients - you - are subjected to the same fashion pressures. Everyone one wants the "best" for their family and themselves. The "best" is often thought to be the newest. The latest smartphone is always the best.
This doesn't work in surgery or medicine. It takes up to 20 years and between 600M and 1 billion dollars to produce a new drug. New drugs are old drugs before you can buy them.
Surgical implants and techniques are never subjected to the same rigorous testing that drugs are.
Surgery has always been a continuous human experiment.
While we certainly do far more laboratory testing than mid 20 century and before, at the end of the day, the outcome of change can only be determined by doing the operation on humans.
Most countries do not have a central database of these experiments and the data from the experiments is held by the companies that pay for them. This is slowly changing, but is still the case.
This is why I have a section on the fabrication of science - see below.
Just a few facts:
There is NO study that shows robots improve patient outcomes in surgery. None, not one.
The more minimally invasive surgery is, the more it requires higher does of radiation, and longer surgical times. There is a compromise at which point making a smaller cut means more complications.
Hip replacement implants that were available in 1996 have not been surpassed in longevity by any new implants.
More complexity means more cost. New techniques should be lowering the price of medicine and surgery, but despite this it goes up at about double inflation every year.
Richard HortonScientific Editor of The Lancet June 2015
“Much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.”
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https://www.macleans.ca/society/life/when-science-isnt-science-based-in-class-with-dr-john-ioannidis/
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