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"The thing always happens that you really believe in; and the belief in a thing makes it happen."
Frank Lloyd Wright

In support for the lack of evidence for the reliability of the Randomised Controlled Trial ‘gold standard’

The international drug firm Merck agreed with the US Department of Justice on 22 November to pay $950m (£615m; €720m) to resolve criminal and civil charges over the promotion and marketing of its painkiller rofecoxib (Vioxx).

In 2007 Merck paid $4.85bn to settle about 26 000 lawsuits relating to the drug in state and federal courts (BMJ 2007;335:1011, doi:10.1136/bmj.39398.517176.DB).

The recent fines relate to a long Justice Department investigation of Merck’s promotion of rofecoxib.

BMJ 2011; 343 doi: 10.1136/bmj.d7702 (Published 28 November 2011)  -  Cite this as: BMJ 2011;343:d7702
Unlike drugs, bioactive substances pose minimal risks when consumed in the nutritional range, and provide
evidence for efficacy from a totality of evidence beyond the prospective randomized controlled trials (RCT)

Nutra: IADSA calls for recommended intake level rethink By Shane Starling , 02-Nov-2011
King's Fund: The government has introduced a range of initiatives to improve the population’s health, including targets on reducing preventable deaths through coronary heart disease, cancer and suicide. It has also emphasised its commitment to evidence-based policy making, and wants to link public investment to an understanding of ‘what works’. But assessing the impact of public health initiatives remains challenging. This publication claims that conventional approaches to building up an evidence base are unhelpful, and proposes a new framework. It forms an open response to the Health Education Authority's consultation around ‘Evidence Base 2000’.
Stephen Daniells: Food Science Reporter for and He has a PhD in Chemistry from Queen's University Belfast and has worked in research in the Netherlands and France.
The Royal College of Nurses: “The RCN supports the principles on evidence and public health articulated by the Kings Fund” - House of Commons (refer to ‘Evidence and Public Health’ on this page)
Consultation on the development of National Occupational Standards for Psychological Therapies
Nicola Player and David Mathews for ‘Skills for Health’
School of Health and Related Research - University of Sheffield
British Medical Journal: BMJ 2003;327:1459-1461 (20 December), doi:10.1136/bmj.327.7429.1459
Leon Chaitow - Positive Health: August 2006; 126:39-40
Paul Dieppe: Journal of Holistic Healthcare: August 2004; Vol 1, Issue 2, Page 12

In its quest for acceptability, CAM is being inappropriately drawn down the biomedical research route. Biomedicine and biomedical research are only a small part of the answer to our healthcare needs and CAM practitioners should resist these moves. CAM works in a different way and that is what needs to be accepted.
BMJ  Coyne 333 (7574) 916

That industry sponsored meta-analyses differ in conclusions from Cochrane reviews does not mean that industry sponsorship is the only source of bias or that Cochrane reviews should be uncritically

Allegiances of authors of meta-analyses are not only associated with selective attention to relevant studies and more positive conclusions in the case of industry ties.
NutraIngredients - 28 Sep 2011
Source: Nutrition - Volume 27, Issue 10, Supplement , October 2011, Pages S1-S20 (doi:10.1016/j.nut.2011.04.002 )

"Evidence based medicine is clearly not appropriate for the evaluation of claims made on foods”
BMJ 2006;333:782 (14 October), doi:10.1136/bmj.38973.444699.0B

Cochrane reviews are sometimes conducted on literature that is not ready for meta-analysis, with adverse implications for clinical practice and public policy. A recent Cochrane meta-analysis concluded that couples therapy was not better than individual therapy for depression.3 The offering of couples therapy should be a matter of "patient preference and availability of specific resources." Yet, the studies reviewed were all seriously flawed. 
"The main lesson, though," says Dr. Michael Miller, editor in chief of the "Harvard Mental Health Letter," "is that positive results in a study conducted by a program's developers are not sufficient evidence to make a program into a model that can be routinely applied by others in different circumstances."
(Medical News Today April/07)
US drugs giant Merck is to be fined an initial $20m after losing a case brought by a user of its Vioxx painkiller.
The jury awarded $18m to Frederick Humeston, who suffered the heart attack after taking Vioxx for knee pain, and a further $2m to his wife.
Merck faces some 7,000 outstanding lawsuits connected to Vioxx, and experts have estimated its potential liabilities in the matter at over $5bn.  (BBC March/07)
Below are some of the reasons why we do not rely  on Randomised Controlled Trials (RCTs - the ‘golden standard’) as the only source of evidence for pain management or other health interventions.  RCT and any other forms of assessment are only used as a part of the whole appraisal process.  When research is used as evidence on this website, it is generally because it makes some logical sense  in relation to other known facts and not because it is the absolute truth.  
CHRONIC PAIN. Intlife Pain Clinic. Evidence-based evidence.