Which Treatment Is Best? Proof in the Past and Present

"Doctor don't let me die," from a young woman serves to focus the physician's mind. Have I given the best medicine? How do I know? What proof is there? The layperson will be helped by thinking from the physician's point of view. One would think the method enabling us to conquer disease and restrain death would be written about so often that we would tire of the story. Not so. There are only limited accounts of the randomized controlled trial. This text attempts to rectify the...
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"Doctor don't let me die," from a young woman serves to focus the physician's mind. Have I given the best medicine? How do I know? What proof is there? The layperson will be helped by thinking from the physician's point of view. One would think the method enabling us to conquer disease and restrain death would be written about so often that we would tire of the story. Not so. There are only limited accounts of the randomized controlled trial. This text attempts to rectify the situation.While there are treatments for everything, the question is do they work? Not only that, are these treatments harmful in subtle ways? Most untested medical treatments are either ineffective or even harmful. The harm is often explained away as a complication of the disease being treated. The presentation here is to help the reader find the gold in medical treatments proven effective by proper scientific testing.The story starts out with describing the medical theory that held sway for more than 2,000 years. Then smallpox vaccination begins an era of comparing numbers. Next we tell stories of charlatans and testimonials. Later we focus on controlled trials. Extracts of humor help keep the reader's interest. The chapter on the goat gland doctor who transplanted goat glands into men to rejuvenate them will captivate the reader. Mathematics is kept to a bare necessity. There is no attempt to teach complete medical statistics. The focus is the interpretation of the randomized controlled trial.The text will help those facing life and death decisions.