@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam For any widespread intervention (screening, treatment): yes. Because the risk of false positives has significant consequences. But for other issues, yes, other criteria for evidence must be established.
The important thing is to set them in advance. For example :
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam To determine whether a treatment can be harmful, more than just high-quality RCTs are needed...:
Data triangulation...
But criteria are needed to assert that the treatment can be harmful.
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam Each question has answers provided by different methods.
The important thing is to define in advance what transforms data into evidence.
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam Finally, the philosophical question behind this is: is it the method or the situation that transforms a study result into evidence (useful for decision-making)?
GRADE, through its inductive method (rather than hypothetical-deductive), has chosen the second option.
I assert that
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam I assert that only the method should determine what constitutes evidence. ...
• • •
Missing some Tweet in this thread? You can try to
force a refresh
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam Finally, here is where our disagreements stem from: I take as a model the regulation of medicines, which sets the rules for marketing authorization: these rules therefore establish criteria for evidence (consensus), which are, incidentally, subject to change.
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam But that is what is required for EBM... otherwise, everything is evidence! jamanetwork.com/journals/jama-…
@dnunan79 @LGHemkens @RecoveryDoctor @GuyattGH @AnilMakam An example: David, Lars, Gordon and Anil:
Metformin in T2D: so what? Evidence or not?
Does everyone see what they want to see?