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Tarnished Gold: The Sickness of Evidence-based Medicine Paperback – October 17, 2011


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Product Details

  • Paperback: 342 pages
  • Publisher: CreateSpace Independent Publishing Platform; 1 edition (October 17, 2011)
  • Language: English
  • ISBN-10: 1466397292
  • ISBN-13: 978-1466397293
  • Product Dimensions: 6 x 0.8 x 9 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.2 out of 5 stars  See all reviews (13 customer reviews)
  • Amazon Best Sellers Rank: #1,169,782 in Books (See Top 100 in Books)

Customer Reviews

Hickey and Roberts are a force to be reckoned with!
Daniel L. Scholten
The book has profound implications for the way medicine is currently practiced, and proposes common sense solutions.
Richard Amerling
This book provides an excellent analysis of evidence based medicine (EBM) and its shortcomings.
William B. Grant

Most Helpful Customer Reviews

15 of 18 people found the following review helpful By Arkadiy Dubovoy on December 22, 2011
Format: Paperback Verified Purchase
With this book Steve Hickey and Hilary Roberts intend to drive a wooden stake through the heart of Evidence-based Medicine. The premises of the book are straightforward: EBM is a marketing ploy; it is irrational and unscientific; it is authoritarian and legalistic; EBM is cookbook medicine dangerous to patients' health and wellbeing [p.22]. The authors are straightforward in their assessment of EBM as an irrational unscientific tool for political control of medicine. No "but's" and "if's," no excuses, no redeeming qualities (all right, Epidemiology, this is not your fault, you are a legitimate field of inquiry, but this monster child of yours needs to go).

The arguments are lucid and unequivocal, and the writing is excellent. There is a very good discussion of statistical probability, Bayesian logic, heuristics, and general scientific method as applied to medicine. That alone is worth the price of the book.

Physicians' criticism of EBM may be perceived as self-serving and biased. The authors, however, are not medical doctors, and they emphasize repeatedly that their opinion of Evidence-based Medicine is a point of view of an educated patient. This should not be ignored. You may or may not agree with the presented arguments, but if you are a conscientious medical practitioner, you owe reading this book to your patients.
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4 of 5 people found the following review helpful By Robert P. Heaney on December 8, 2012
Format: Kindle Edition Verified Purchase
This is a deeply disappointing book. There is no doubt that evidence-based medicine (EBM) is a seriously flawed system. In fact it's a textbook example of the emperor having no clothes. I had hoped for an insightful analysis of why the emperor is in fact naked. I suspect that that's what the book's authors thought they were providing. Unfortunately, we get Instead a seemingly endless series of chapters telling us what they're going to tell us, followed by tangential excursions into information theory, complexity, decision science, and other topics which come across as a "dump" of everything the authors know about everything. Yes, I know, there is a connection among all these topics. But it just doesn't work. Finally, at least on my Kindle, the book has the flaw I've found in several other "Kindle-ized" books: the graphs are difficult to read (or even visualize!). I don't know whether it's a flaw in the Amazon system or in the publishers' preparing the contents for transfer to Amazon. Still, if you want this book, get the print version.
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1 of 1 people found the following review helpful By Faiz Khan MD on June 17, 2014
Format: Paperback Verified Purchase
Well - I am not quite sure what the negative reviews are about. First my qualifications: A physician scientist (published and speaker nationally and internationally) and physician executive, with over 10 years as a program director in an elite residency program. My areas of focus covered diagnostic reasoning, epistemology, basic sciences, critical care, analyses of clinical trials, and medical humanities. Any intelligent physician begins to intuit what the authors are explicitly stating - perhaps their use of examples from medical doctrine need a bit more refinement - but the elucidations of how foundational principles of science are cast aside in the quest for medical 'progress' is spot on. Fraud, bias, and simple misapplication of statistical inference is 'prevalent' - and it is a truism that research agendas are guided by industrial agendas - as are 'best practices.' Physicians are shaped to become cogs in the finance driven 'health care delivery industry,' rather than guardians for their patients medical care. Many folks, (parasites) are able to extract egregious amounts of money in this industry while, at best contributing little (but usually detracting from ) access, efficiency or quality of medical care. This book is a must read for all physicians.
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15 of 22 people found the following review helpful By Andrew W. Saul on October 26, 2011
Format: Paperback
This important book utterly takes the wind out of the sails of so-called evidence based medicine, the latest fad of pharmaceutical medicine. I do confess to being biased, as 1) I am on the editorial board of a nutritional medicine journal, and 2) I have coauthored two books with Dr. Hickey. However, I think "Tarnished Gold: The Sickness of Evidence-Based Medicine" is especially well done, and greatly needed. Look around you: people are sick and medical costs are through the roof. How should we, and can we, fix a system like this? What treatments work best? How do we know? There have been so many conflicting medical studies and equally confusing news reports about them. We have to be able to make sense of research methods, sample sizes, statistics, and identify bias. Indeed, it is a daunting task, and not everyone wants to try. But if you do indeed want to settle matters for yourself, you need this book. Study significance and analysis and decision science are not everyone's best friends. This is why it is good that we can turn to Steve Hickey and Hilary Roberts. They truly are skilled at making the cloudy and incomprehensible into the clear and very sensible. As I read through this book, again and again I thought, "So that's how it's done. Of course." Not only that, the book is not difficult to read, and I think, very enjoyable with a good sense of humor. But the subtitle tells of the more serious tale: the evidence-based medical emperor has no clothes. What Mark Twain said of Wagner's music applies to evidence-based medicine": it sounds better than it is. Reading this book is worth your time. Well worth it.
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