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Describe your topic

Evidence-based Practice (EBP) can produce populations of patients who are systematically, unscientifically, and unethically denied therapy unnecessarily. Medicine and Evidence-based Medicine (EBM) produce claims to validity via confirming studies. These claims can be false just as the ancient claim that all swans are white. This claim withstood a vast number of confirming observations in Europe until an explorer found a black swan in Australia. In spite of counterexamples being valued in science, they are dismissed in medicine and EBM as mere anecdotes. In other words, medicine systematically declines to learn and produce higher quality EBP. Sir Karl Popper pondered the problem of confirmations in theories by Marx and Freud. Being far more skeptical than medicine, he claimed a conjecture can only be scientific if it can be tested and does not have counterexamples. The victims Chronic Symptoms of Hypothyroidism suffer because the definition of hypothyroidism does not implicate cellular thyroid hormone deficiencies, but that where the symptoms come from. Cells are where the action is. The action of thyroid hormones is not in the circulating blood where the assays are taken. So the serum assays are an incomplete assessment of the patient's condition. A 1999 study by Bunevicius, et al., found the "evil" but most active thyroid hormone actually produced better results than the standard levothyroxine therapy. In lieu of analyzing their data, the endocrinology establishment produced numerous studies. This data swamped the Bunevicius data. The low-rate ignoring analysis then found Bunevicius was mistaken. In reality, he and staff found an endocrinology "Black Swan" in a population with an on-average deficient peripheral conversion. But endocrinology assumes that this can not exist. Contrary to allopathic medical philosophy, all thyroid-hormone-related functions in the "peripheral tissue" operates properly in all people for their whole lives. Really ! As a consequence of EBM-compliant meta-analyses, the most active thyroid hormone was declared ineffective. This should have raised more than a few eyebrows. But EBM's excessive evidence exclusion, which goes far beyond the Federal Rules of Evidence, dismissed the work of Drs. Gross and Pitt-Rivers as well as the discoveries of these ignored functions in the peripheral tissue and all studies pointing to this problem. So much for using the best evidence. EBM posits false evidence from a randomized clincal trial (RCT) is better than true observational evidence. Since T3 was falsely found to be ineffective and has a shorter-than-thyroxine half-life, the endocrinology establishment proscribes it in EBPs. Consequently, those patients who do have post-thyroid deficiencies in the peripheral tissue suffer with the symptoms of hypothyroidism and generally do so for the balance of their lives. However, a few of these systematically abused patients find physicians, who honor their medical ethics more than they fear discipline by their boards of medicine, and get treated with a T3-containing therapy. These patients plus a few from ignored medical science are counterexamples to this systematic abuse of patients. Per Sir Karl Popper's vaunted philosophy of science, their condition should be studied to modify or extending existing EBPs. Per Saravanan, et al., there may be 1.7 million such folks, mostly women, in this country. Similarly, Chronic Lyme Disease is alleged to not exist because the diagnostics are deficient and extended antibiotic therapy is proscribed. Nonetheless, some ethical physicians have treated and do treat patients with Chronic Lyme Disease. Their successes are also counterexample to the systematic abuse heaped upon them by the infectious disease establishment. The demand for extensive published evidence is contrary to the widely accepted philosophy of science by Sir Karl Popper. He called for skepticism of alleged validity produced by confirming studies - the medical science method, which was found lacking long ago and is still lacking. If AHRQ were serious about improving healthcare it would foster counterexamples to practice guidelines to expose their shortcomings and to consequently improve the health of the nation. Now, one must ask if the nation's health is more or less important than medical establishment egos.

Describe why this topic is important.

It is important that medical evidence be valid and not just seemingly valid by way of ignoring counterexamples.

Tell us why you are suggesting this topic.

There are patient whose health is systematically, unscientifically, and unethically maintained in a low state. I.e., they are kept unhealthy.

Target date.

As soon as possible - people are suffering unnecessarily.

Describe what you are doing currently and what you are hoping will change because of a new evidence report.

I have written three medical journal articles that describe endocrinology's maintenance of unhealthy patients. These journal articles cover the entire process from disease definition to the existence of thousands of patient counterexamples. The EBPs for hypothyroidism make recommendations beyond their scientific support and should have their scope of applicability appropriately limited. I am currently writing my fourth article that emphasizes how Sir Karl Popper's philosophy improves health care where patients are currently denied healthcare systematically. My wife and numerous relatives are counterexamples to the hypothyroidism EBPs. They must have a proscribed triiodothyronine (T3) containing therapy to live active, attractive lives.

How will you or your group use the information from a new evidence report?

This is not a proper question. The problem with getting a T3 prescription is that its proscription is threatened to be enforced by state board of medicine discipline. Since this proscription is total, it is contrary to the Supremacy Clause of the United States Constitution since the Food and Drug Administration has field dominance over the states. So they can not prosecute any physician for the mere prescription of T3 containing therapies per US Supreme Court in Shelley v. Kraemer. This illustrates the problem in the medical establishment - there is no punishment available for directing vast medical malpractice.

How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?

Given sufficient funding, I would disseminate it to boards of medicine, practicing physicians, and patient advocacy groups via attention getting informative means.

Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?

There are "thyroid" patient advocacy groups around the world who would like to advise their members of potential relief of their chronic suffering.

Information About You: (optional)

Provide a description of your role or perspective

I am a patient advocate who has studied this problem for 14 years.

If you are you making a suggestion on behalf of an organization, please state the name of the organization

Metis Research, Inc.

Please tell us how you heard about the Effective Health Care Program

Email from AHRQ.