Evolution meets evidence-based medicine


This is the EvolutionMedicine ‘cast #4, a bonus podcast for Saturday July 23th – evolution meets evidence-based medicine. This podcast is based on a presentation I gave at last month’s ISEMPH conference. A couple of weeks ago, we discussed how an evolutionary hypothesis regarding sepsis physiology was ultimately vindicated by evidence.  Xigris’ demise was the culmination of over 1000 publications, but a final well designed randomized controlled trial was the final nail in Xigris’ coffin.

Xigris’ failure was an example of the evidence-based medicine (EBM) dovetailing with predictions of evolutionary medicine. EBM is a movement in medical science that makes receommendations based on the best evidence provided by clinical trials. The hierarchy of EBM is shown here:

Screen Shot 2016-07-13 at 2.45.55 PM

Randomized controlled trials are the best quality evidence, especially when synthesized into systematic reviews.

If evolutionary medicine (EvMed) is a useful enterprise that produces better patient outcomes, then EBM and EvMed should overlap more often than not. Lets see if this proposition holds up, starting with evidenced-based opioid pain medication prescribing.

Here is our question: Should I prescribe an opioid pain medicine for patients with chronic musculoskeletal back pain?

Listen to the podcast:

Slides for this talk are available here

 

 

 

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