Friday, June 22, 2007

Are anticoagulants beneficial for venous thromboembolism?

For most of us the answer is yes, but not if you’re an EBM purist. Dr. David Cundiff has been stirring the pot by asking some tough questions about VTE treatment in a couple of articles in MedGenMed. Dr. Roy Poses cites the two articles in a recent Health Care Renewal post. Although, as he points out, these papers received no attention in the press, the first article caught my eye and was the subject of a post of mine in October 2005.

At that time I pointed out that although anticoagulant treatment of VTE is not “evidence based” in a strict sense, the totality of evidence in favor of anticoagulant treatment is compelling. I also cited this paper which is a must read if one wants a balanced and thorough analysis of the literature on this subject.

Dr. Poses, discussing conflicts of interest surrounding the debate, focuses on money. I believe, though, he placed too little emphasis on Dr. Cundiff’s non-financial conflict which I mentioned in my 2005 post.

No comments: