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[Diagnostic and therapeutic misunderstandings derived from case-control studies and meta-analyses]
1Unidad de Investigación Médica en Endocrinología, Diabetes y Metabolismo, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), México, D.F. zaratre@att.net.mx
Abstract:
Up to now, clinical trials and meta-analyses have been considered as essential for medicine, based on evidence and clinical practice, but recently there has been controversial information in the scientific literature regarding the diagnosis and treatment of several maladies. It was generally accepted that early detection of cancer could lead to appropriate and successful treatment, in particular in cancer located in breast, prostate gland, colon, and lungs. Nevertheless, there are reports which show the difficulty to detect the malignancy and development of cancer. As to the use of medicaments, the controversy arises from the possibility of undesirable side effects, which limit their beneficial effect. Likewise, long-term treatment of chronic diseases makes the prediction of adverse effects difficult. It is concluded that the physician should analyze all sorts of information, including that originated from observational and personal experience, in order to reach a correct diagnosis as well as the appropriate therapy. There are no truisms originating totally from clinical trials and meta-analyses.
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