Surgery and Double Blind Studies?

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MedicinaeDoctor

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Just about everyone knows that surgery works. However, I was wondering how surgery can ever be rigorously tested under double-blind conditions, without any sort of experimenter's bias, considering that the surgeon would always know that he or she is performing a "fake" surgery? Has surgery ever been truly "proven" in solid scientific studies or is it just an accepted medical reality?

How much of medicine is "proven"? How much of medicine is evidence-based medicine? How much of evidence-based medicine is driven more by political and economic factors, than compassionate and scientific care?

I was just curious more than anything else because it recently hit me that some are skeptical of some of the musculoskeletal benefits of OMT, but the same people are not skeptical of other aspects of medicine that "works because it does," rather than works because the vast majority of research says. I'm asking, rather than accusing.

As a pre-med that will be applying to MD and DO schools, I really just want to know about some these issues that I brought up and was hoping some of you med students could provide insight.

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Medications are double blinded so that the physician doesn't subconsciously act in a way that would let the patient know whether he or she is on the placebo or the actual drug. This really isn't an issue for surgical interventions, but it can be for OMT. I'm a DO student as well, and I do believe that at the very least some of the principles of OMM is valid, but I can understand why people are skeptical.
 
Just about everyone knows that surgery works. However, I was wondering how surgery can ever be rigorously tested under double-blind conditions, without any sort of experimenter's bias, considering that the surgeon would always know that he or she is performing a "fake" surgery? Has surgery ever been truly "proven" in solid scientific studies or is it just an accepted medical reality?

How much of medicine is "proven"? How much of medicine is evidence-based medicine? How much of evidence-based medicine is driven more by political and economic factors, than compassionate and scientific care?

I was just curious more than anything else because it recently hit me that some are skeptical of some of the musculoskeletal benefits of OMT, but the same people are not skeptical of other aspects of medicine that "works because it does," rather than works because the vast majority of research says. I'm asking, rather than accusing.

As a pre-med that will be applying to MD and DO schools, I really just want to know about some these issues that I brought up and was hoping some of you med students could provide insight.
i have heard of test surgeries being done on animals where the animal was put under, cut open, and then sewn back together without doing anything else to them. i know it isn't exactly what you were asking about, but their response compared to an animal that actually had the surgery done would show results.
as far as double blinding omm, i can't see how that would happen. the physician would know, as you said, that they're doing a sham treatment. an unskilled lay person asked to perform the treatment would be likely to do more harm than good, and they would also know that they don't know what they're doing (same situation as someone who knows they're doing a sham treatment). i think thought that if the only evidence would be that someone feels better afterward, it's worth it to me. it may not fix the problem permanently, but if it can help with the symptoms or manage temporarily, then why not? it's the same with many other medical interventions for other chronic ailments. diabetes, for example, isn't fixed, just managed. so if omm can also manage a problem, i'm all for it. and as a disclaimer, i haven't started yet, but i'm definitely looking forward to having omm help with my back pain :D. i'll let you know how my views change/grow once i start (if you're genuinely interested in any kind of follow up).
 
For both surgery and OMT, you can do single-blind studies, but not double-blind studies to help prove effectiveness.
 
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