[SpinLyme] The Misuse of Evidence-Based Medicine
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Subject: Re: [SpinLyme] The Misuse of Evidence-Based Medicine
Date: Feb 10, 2008 2:07 AM
You can't expect fruition from a critical analysis of all of Kaiser's
crimes,
because that would require a critical mind from a lawyer or lawfirm.
Such a thing
does not exist. They mutually exclude. No one goes into law school
and comes out
without a desire to deceive, which is the very thing that precludes
the ability
to think.
We've already done all the RICO investigative work, but the "US
Attorney"
is a corporate ho. A drinker of King George's Kool-Aid. He's the
worst
kind of lawyer:
http://www.actionlyme.org/USDOJ_COMPLAINT_RICO.htm
There's this huge barrier to actualizing the return to science of
medicine,
because lawyers know the value of psychiatry. They can get any
psychiatric ho to
say anything they need in "court," and we can't expect "judges"
to know the difference between fact and opinion, since they themselves
are authors
of rationalizing opinion by selecting the law to fit the intended
outcome.
These are mostly men, these lawyers and "judges," who actually deploy
the worst of the fairy-ass high school girl games of Who's Your Best
Friend.
They don't even realize it. They don't even realize that there are
rules
of logic and science. They don't realize that one cannot have opinion
in the
presence of science, since science is about getting rid of the
opinions.
Americans no longer know how to think, at all. They don't understand
that there
is an obligation in knowledge.
Take for example the notion of test kits over actually laboratory,
actual chemistry/analytical
systems-based detection of markers of disease:
http://www.actionlyme.org/BIOMARKERS2.htm
The crooks want to sell "test kits," which are about as accurate for
detection
microquanities of analyte as a magnifying glass is good for looking at
viruses.
How is having fewer and fewer lab technicians running real analyses
going to lower
costs for the government who ends up paying for the people who advance
so far into
disease states that they are now disabled Medicare recipients? This
we know was
Kaiser's goal, but wouldn't the entire DHHS be responsible for keeping
down
such costs by looking into this "test kits" and psychiatric
imaginators
replacing real medicine?
How can you say such things to the USDOJ as it now is?
Plain English does not work, like it does not work for psychiatry.
This is simply not solvable, because this country has no intelligent
life left at
all. We've been complaining about these exact same crimes since the
Summer
of 1999:
http://www.actionlyme.org/Actionlyme_History.htm
Lyme is the cause of at least 25% of the chronic illness in America,
since that's
the number our own scientists come up with for MS, while in Poland
they say 36%
association of Lyme to an MS outcome, and the crooks say 47% is the
number of ALS
cases associated with Borreliosis. In 1975 before the very stupid
Allen Steere
came along, syphilis gave the exact same outcomes as Lyme to the tune
of 1/6 to
1/3 of all cases.
1/6 to 1/3 of all syphilis cases had outcomes like Lyme, and the CDC
knew this from
the Tuskegee Bad Blood "study."
Note that 1/6 to 1/3 is the same general percent of MS-like outcomes
for Lyme.
And now tick borne diseases are the biggest European and North
American pandemics.
Will that go away by allowing the CDC-tards to lie about it some more?
There is simply no explanation for this much incompetence by the DHHS
and the USDOJ.
The DHHS and the USDOJ (and the New York Times) make an international
spectacle
of themselves. They have clearly made a judgment to ignore all of
this, but why
should we trust the judgment of such lying retards?
This is actionable:
http://www.actionlyme.org/CRYMEDISEASE_CHP3.htm
People say the case definition is different from the treatable
definition, but that
is scientific fraud. It is not scientifically valid according to the
FDA's
own rules. 5 times 100% does not more equal 100% than 1 times 100%.
Requiring 5 times 100% means that >80% of the cases will be missed.
There was no consensus at Dearborn.
Even Gary Wormser reported that Steere's method only detected 9/59
cases in
IgG.
So, it is complete and total bullshit for the CDC to claim that the
case definition
more assures a case of Lyme for case-counting purposes.
That is not how science works.
There is some other reason the CDC does not want Lyme diagnosed and
treated. Perhaps
it is like Kenneth Marcus committing perjury on behalf of James
Phillips' malpractice:
http://www.actionlyme.org/PHILLIPS_MARCUS_PERJURY.htm
The CDC is covering for their officers' (Steere, Barbour, Klempner)
crimes?
No matter what the reason, the whole world knows what these clowns did
and are taking
a serious interest. They can see the US is full of crap no matter
what the topic.
Kathleen M. Dickson
-----Original Message-----
>From:
>Sent: Feb 10, 2008 1:13 AM
>To: Spin...@yahoogroups.com
>Subject: [SpinLyme] The Misuse of Evidence-Based Medicine
>
>http://drphillips.kaiserpapers.info/november142007.html
>
>The Misuse of Evidence-Based Medicine
>
>November 14, 2007
>
>"Evidence Based Medicine" was the original dream of an accountant
in England named Archie Cochrane. He decided that if all of the
medical articles
in the world could be synthesized into pure knowledge - and weighted
toward levels
of certainty - then out would come a central logic of what to do in
most or all
situations. And so the Cochrane Collection was created and is ongoing
on the Internet.
To itself it is fairly pure and unbiased - like a glacier on the top
of the mountain.
>
>England was the first to try to manipulate the collection to the government's
supposed benefit and decided that at York there would be clinical
testing or validation
of the Cochrane evidence. They immediately picked out those topics
where they might
save money - so that less care could be given if possible to so
prove. Pure knowledge
is budget neutral - creating more care for some problems and less for
others. But
to no one's surprise the government paid for and got back what it
wanted - minimalist
care.
>
>The actual term "Evidenced Based Medicine" or EBM was dreamed up in
the Family Practice Department of McGill University. They have
conceded that what
they really wanted to create is "Expert Absent Medicine." Clearly it
would be cheaper to punch up the computer than asking real experts.
Instead, the
practicing physician was to become dependent on reviews of reviews.
The physician
- burdened by medical school to be free thinking and challenging to
the changing
world of science - could now simply leave the thinking to others. In
fact, there
is even a bizarre approach to give every symptom a diagnostic weight
so in combination
the physician analysis is no longer needed.
>
>The rivalry between narrative medicine (the careful interview of the patient
and building up of diagnostic clues) is still championed by Harrison's
Textbook
of Medicine. The rival Cecil and Loebe has allowed its diagnostic
chapter to be
written in the EBM style of weighing symptoms computer style.
Harrison acknowledges
the advances of evidence but still finds the most complex of medical
skills - a
good interview - to be best governed by and then taught by experts.
In terms of
our glacier, we are starting to work our way down to the forest of
animals and their
discharges into the mountain streams.
>
>HMOs decided that EBV if yoked to their goals of "the less we do the more
money we make" (Kaiser CEO to Nixon summary in SICKO), then the public
would
have no legal defense against being victimized by disease. It goes
along with illness
being life style created so being sick is about the same as being
bad. Thriving
is something joggers do each morning, not really a promise of a
prepaid health plan.
Experts - on the Kaiser Website - were once pictured as old men with
simply the
halos of balding hair. After I pointed that out, the Website morphed.
>
>To see the "malignant heart" approach used by HMOs in blocking care,
one needs to hold side by side the original evidence against the
"evidence"
within the secret Guidelines and Pathways of the HMO. The American
Diabetes Association,
for example,states that all couch potato types need to be tested for
diabetes rather
than waiting until a few show up suddenly needing dialysis. Kaiser
carefully changed
this recommendation so that such folks would not be tested in a chart
that almost
matches but has been fudged toward less care. At the same time the
for profit Permanente
physicians carefully invested in dialysis ventures.
>
>In such a case, all risk is shifted to patients. Disease become the internal
ovens that cook from within. In fact, the perfect art of HMO EBM is
to catch diseases
right at the point of dialysis or hospice - as new federal money
suddenly pours
in. If cancer is diagnosed just late enough, it can be declared
hopeless just as
it is found. legally, the HMO's care cannot be challenged if the
chance of
cure drops below 50%. And the medical records are spoiled anyway by
Risk Management
- so who cares?
>
>Perhaps the easiest example that one can follow of the perversion of EBM - somewhere
near the polluted delta where swimming is not allowed - is that which
Kaiser produced
by "partnering" with the Communicable Disease Center for anthrax
diagnosis.
Kaiser stated that a low oxygen level was a good screen for anthrax.
The CDC explained
that Anthrax - though inhaled - often bypasses the lungs on the way to
mediastinal
involvement and shock; low oxygen would only be a too late sign.
Kaiser intent
in its release of a protocol was to cover up missing an anthrax
patient and actually
set up to NOT catch the next case.
>
>Yet, for Kaiser - on their Permanente Medicine Map - the only way to the "Sustainable
Future" for the fleet of Permanente (pictured as a group of ships) is
through
the straights of EBM. This is the pathway for each partner physician
to end up
with a millionaire's pension, e.g. $15,000 a month plus social
security. But
the partners can never tell the above tale because the pension is all
potentially
gone if the same physicians do not support the HMO and its expansion
(yes - in writing).
This is the great "gag" clause.
>
>Like all good ideas that get translated into profit, evidence based medicine
is now so contaminated with dysinformation that it is dangerous. With
EBM nurses
will hold out in HMOs to be practitioners - though only RNs with no
diagnostic training
- and withhold antibiotics from all but those yelling for them. And
since it is
"evidence," it does not matter if it is given out by the least
qualified.
The patient history - 90% of diagnosis - is tossed out the window as
time consuming.
After all patients are simply "the worried well" using up health
dollars
instead of eating broccoli. Judges will find themselves weighing
competing "evidence"
journals - medical experts no longer needed in court.
>
>I sound like the near extinct physician eagle flying over the canyons of the
past. But then I am comforted to know that ER physicians in general
have remained
skeptical about this new panacea of information. In fact, the lead ER
journal noted
that by the time "evidence" has gone from the source to the frontline
it has passed through 11 prisms of value judgment. The
"retrospectoscope"
is not as clear as we had hoped.
>
>When I get sick, I will look for an expert. That expert will be able to quote
all the current lead articles but will also bring to bear experience.
And, yes,
his or her white coat will really stand for the oath of patient
loyalty. For that
moment in time, I will be the north star around which the medical
world revolves.
I will have a champion willing to take on the dragon of disease. I
will not be
a stepping stone to the expert's retirement plan.
>
>Sorry, Archie. You had a good idea. We need to perfect the collection and
selection of knowledge. But there are white coats and green coats.
Until it becomes
profitable to give superior care, "evidence" is often just the pathway
to doing nothing.
>
>
Chuck Phillips, MD, FACEP
>
Former Kaiser Permanente Physician
>
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