Medicine should always be evidence-based. That's a given. So, do we need courses and science communication efforts on evidence-based medicine? Unfortunately, we do. What should be obvious sometimes needs to be taught. And the pandemic highlighted just how badly we need to teach our medical students and doctors to assess and understand scientific evidence for drugs, vaccines, and treatments.
The fact that we have been discussing all sorts of miracle cures for COVID-19, ranging from hydroxychloroquine and ivermectin to ozone therapy and homeopathy, shows how fragile our grasp of evidence is. This is not new. It just hasn't been such a huge part of the public debate — until now.
Here in Brazil, evidence-based medicine was already a challenge before the pandemic and is one of the reasons for the creation of Institute Question of Science (Instituto Questão de Ciência - IQC), the NGO that I preside, whose main goal is to promote science-based public policies.
When IQC was founded back in November 2018, we had no idea that our work would soon become essential in Brazil. We had just created the first Brazilian organization for the promotion of rational thinking and skepticism, and a year later, the pandemic hit us. We expected to work with misinformation in health policies, but we never expected that the range of our work would soon help to fight misinformation on a global level.
It soon became obvious how much Brazil — and the world — were in desperate need of rational thinking.
Being experienced with debunking fake news and conspiracy theories, our team took on the mission of tackling COVID misinformation. We have been publishing extensively about vaccines, drug development, lockdown and preventive measures, and mask wearing, and all of this in a country led by a denialist government. Fighting misinformation coming directly from the federal government and the Ministry of Health is not an easy task, but it's one we took on fiercely, and so far, we have succeeded.
Our magazine has an average of 100,000 readers a month, and I write a weekly column in one of Brazil's largest newspapers and feature two weekly talk shows in one of our main radio stations. I have the honor of being the first Brazilian to be made fellow of the Committee for Skeptical Inquiry in the US, and I received the 2020 international award for the promotion of skepticism, sponsored by The Skeptic magazine (UK), and the Ockham Award.
Getting both national and international recognition for my work is great, but I know that we still have a long way to go. Brazil is probably the only country in the world to have made hydroxychloroquine and other miracle drugs a public health policy for COVID-19. The situation has escalated, so much so that the Senate has implemented a Committee for Parliamentary Investigation to assess the accountability of the federal government for the excess of deaths that could have been prevented with mitigating measures and a planned vaccination program.
It was not by chance that IQC magazine was the first news outlet in Brazil to debunk the infamous French paper that originated the chloroquine hype. A more thorough analysis of the hype was published by IQC members on Frontiers of Communication, where we show that the chloroquine hype was perpetuated by the public and by plenty of Brazilian doctors.
Teaching our doctors, both experienced and young, to evaluate evidence became imperative. This, however, is not something easy to overcome; it requires an effort to change medical school curriculum and to communicate science to the society.
But more than that, it also requires training for medical doctors — not only to evaluate evidence but to communicate evidence to their patients. Many doctors felt pressured by patients and their families to prescribe medication that they knew would be useless for COVID; but for many reasons, including fear of losing their patients' trust, they chose to prescribe it anyway, thinking, After all, what's the harm?
The importance of evidence and the harm of treatments that are not evidence-based will be recurrent themes in this blog. I'm not a medical doctor myself; I am a microbiologist, which makes it easier for me to have an "outside look" at the situation. While I can understand that science is not the only tool in a doctor's office, my goal is to make it available, in a language accessible to everyone, and ultimately to help doctors develop communication tools to help their patients make informed decisions.
In times when misinformation is widespread and easily reached through social media, we have to rebuild trust in the medical profession, making sure that the correct information circulates not only in the media but also, and essentially, in doctors' offices.
Maybe one day there will come a time when evidence-based medicine courses are a thing of the past. Until then, we have to teach it. Just as important as preventing the next pandemic with healthcare measures and genomic surveillance is preventing the next infodemic, preparing our healthcare workers to understand scientific evidence and to communicate with the public. I hope this blog is a good place to start this interaction with the medical community, to make sure that science and medicine walk hand in hand.
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Cite this: Natalia Pasternak. Science and Medicine Go Hand in Hand - Medscape - Jun 09, 2021.