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We’ve broached the subject of unreliable source information for medically-related issues, but we have yet to discuss the means by which we can determine that a particular substance or instrument has been assessed with the application of stringent guidelines and, thus, can be ascertained to be trustworthy and legitimate. In medicine, the randomized control trial (RCT) fulfills such scientific requirements and is considered the so-called gold standard of these evidence-finding research procedures. These experimental trials are set up with the goal of reducing bias. To achieve this, from a group of people (a cohort) individuals are selected randomly to be assigned to either receive a drug (the independent variable) or not to receive the drug (e.g., a placebo or ‘sugar pill’ resembling in appearance the drug being tested). The latter group receiving the inactive substance is the control for the procedure, and is used to compare that group’s outcome against the group taking the active drug ingredient. Often, the experimental design is blinded. This means that the doctor conducting the trial does not know which patients are getting the active or inactive substance. (A double blind means that neither patient nor doctor knows whether the active or inactive drug is being provided.) There is also frequently a crossover built into the study, in which the groups are reversed after a washout period (= a time allotted so that the drug can leave the body). Consequently, the active treatment group would receive the placebo, while the previous group taking the placebo would now take the active ingredient.
The second acceptable procedure offering good medical evidence is a statistical method called meta-analysis. This type of study uses previous investigations (including Randomized Control Trials) and draws a conclusion based on the sum of the studies. One of the benefits of meta-analysis is that it can iron out different conclusions of different studies based on statistical evaluations. Where does one go to find these kinds of acceptable evidence-based practices? Web MD and Medscape are probably okay. Ditto for Consumer Reports (they report more than just telling you how great the Subaru Forrester is). The Harvard News Letter, the Mayo Clinic, the Cleveland Clinic, and the newsletter from Johns Hopkins are well-referenced. I found the Oregon and Health Science site especially good for Parkinson’s Disease information (they have a free course on PD exercise that you can take for credit). Also good sites are the following journals: JAMA, The New England Journal of Medicine and The Lancet. Under the rubric of the AMA are the various medical specialties, each producing a journal of their own. They include the following: JAMA: Cardiology, Dermatology, Internal Medicine, Neurology, Oncology, Pediatrics, Psychiatry, Surgery and Ophthalmology. Perhaps the best and most trusted are the sites run by The National Institute of Health. All of the information and recommendations on those sites are evidenced-based. The CDC also offers reliable information and recommendations. The Parkinson’s Foundation and the Michael J. Fox Foundation are more specifically oriented, obviously, toward PD, and are especially valuable for learning about recent developments and prospects for the future. Lao Du
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