Thursday, November 21, 2013

Cochrane Reviews: What They Cannot For for you - Walter Ling MD - ISAM 2013 Kuala Lumpur

Walter Ling MD
Integrated Substance Abuse Programs (ISAP) UCLA
 IMG 1820IMG 1821IMG 1823IMG 1824IMG 1825IMG 1826IMG 1828

What Cochrane Reviews Cannot Do
A Cochrane Review can only inform
Cochrane Reviews can't transform
Bulk of Cochrane reviews use data generated in the US by US researches
NIDA supports 80% of addiction research world wide
Few US Physicians even know about Cochrane Reviews
Only 1 state gives free access to it's residents: Wyoming

Why Cochrane Reviess are not used in the US
-US medical practice standards are local
-If you get sued in court, the judge is not going to ask these questions, but ask if you are doing what your neighbours are doing down the street
-No National health care system
-emphasis on tradition and personal experience
-Cochrane not 'made in US'
-ideology and societal attitudes and values over scientific evidence - preoccupation with  detoxification, insistence on abstinence (temperance movement, distrust in agonist pharmacotherapy, distrust in harm reduction strategies
-early leadership role widely followed by other countries.
What I'm saying is that just because there is evidence it doesn't mean people will change. There needs to be a process.  If we look at changes and how we become good physicians, we have to have something as part of the treatment philosophy.

US Health Report Car: Shorter Live, Poorer Health
- last among peer nations in health status

Cochrane Reviews cannot help do better research; better research can improve Cochrane reviews.

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