Georg Ivanovas From Autism to Humanism - systems theory in medicine

2.5 The limits of evidence based medicine

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e) time and process

Many studies have the problem of short duration. Longer observation might find other outcomes than the initial results suggest.

  1. A study on epicondylitis shows that an injection with cortisone has immediately the best effect. However, in longer observation it is less effective than physiotherapy or just doing nothing (Smidt et al 2002, Bisset et al 2006).
  2. A study on baby walkers shows that the use of walkers brings babies earlier in an upright position, but they learn later to walk and stand alone (Garett et al 2002).
  3. Babies treated with antibiotics during the first 6 months of their live have a higher probability to develop allergies or asthma (Johnson et al 2005).
  4. Preterm babies fed with a nutrient-enriched diet had a higher insulin resistance in adolescence as in babies fed with lower-nutrition diet such as banked breast milk or a standard formula (Singhal et al 2003; Singhal et al 2004). As a result: Feeding babies up quickly is not as healthy as slow development, although reference values are not reached as soon.
  5. Breast-fed children show a higher levels TC and LDL values. After adolescence however the concentrations are lower than in children not breast-fed (Owen et al 2002).

Already the duration of the last studies exceeds the time frame of most studies on which our knowledge is (evidence) based.

If the principle ‘helps short term – harms long term’ is more common than short studies would be an instruction for damaging.

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