The largely ineffective Agency for Healthcare Research and Quality (AHRQ) has a list of 20 Tips to Help Prevent Medical Errors http://www.ahrq.gov/consumer/20tips.htm
Number 20 on the list is
“Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources.”
It then suggests to ask your doctor if the treatment is based on the latest evidence. The way this is presented it seems to say that doctors and nurses often do not always present treatment options based on the latest evidence.
As argued by Shannon Brownlee, http://www.washingtonmonthly.com/features/2007/0710.brownlee.html the U.S. is clearly in need of an
“… independant agency that would fund systematic reviews of the medical literature, as well as clinical trials to test the comparative effectiveness of everything from drugs to treatments”
Unfortunately the current AHRQ is not performing this service as it was rendered somewhat ineffective thanks to Newt Gingrich and Congress in 1996 over the issue of spinal fusion surgery.
The Agency for Health Care Policy and Research (AHCPR) was created in 1989 to produce evidence-based, clinical-practice guidelines. What ended up happening was the AHCPR panel concluded that there was little evidence to support surgery as a first line treatment for low back pain and that nonsurgical interventions should first be used. The medical device industry and several doctors organizations opposed governmental control over the research and evaluation of new technologies including The American Society of Cataract Surgery, the American Board of Ophthalmologists, and the North American Spine Society.
Sensing a threat to their livelihoods, many surgeons bombarded Congress with letters contending that the agency’s panel was biased and found a sympathetic ear with Newt Gingrich and the Republican House majority. The AHCPR had a budget that became crippled and it’s mission shifted and it became the Agency for Healthcare Research and Quality (AHRQ). As a result, numerous spinal fusion surgeries continue to be performed.
Currently today the American health system is based on scientific evidence as long as the evidence supports commercial interests; but all too often when the science conflicts with commercial interests, science gets nudged aside.
1) Overdosed America: The Broken Promise of American Medicine (P.S.)
John Abramson. Harper Collins Publishers. 2004.
2) Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer Shannon Brownlee.Bloomsbury USA. 2007.