["Wise be aware of your sayings"--about gaps between epidemiological data base, experimental results and decision making in health administration].
When scientific researches are being published one should consider carefully the different possible influences which may change the results. These influences may be of two kinds: Non-Causal explanations, and Casual explanations. Researchers may arrive at their results and not have considered all the causative explanations. Occams's Razor is the basic rule by which most reasonable explanations are chosen. A statistical result and an appropriate simple theory to explain it, is not sufficient to prove causative effect. In many cases though, the media and public tend to accept a statistically significant result as if it was a proven cause and effect relation. There are several conditional demands called Bradford Hill criteria of which epidemiological data and results are only one, the more results arrived by using the Bradford Hill criteria, the better chances exist that the examined variable is the cause for the effect. Finally, there is a gap between a proven causal factor for disease or the harmful effects of treatment and a "clear cut" health policy. There are several intermediate powerful influences which are involved in the process of stating a new health policy. These influences include among others, the involvement of decision makers, political influences and civil service professionals. As an example three different issues of a well proven clinical research will be presented. The research of Rofecoxib = "Vioxx" cardiac effects, the research of Hormonal Replacement Treatment health effects on post menopausal women and the last of Health risks presented by mobile phone use. Although the results of those researches were proven to be statistically significant, Health Policy in each case is different and less clear. Health Policy is not based solely on figures and statistical results, but rather on a far wider and more complex influences and judgment.
Hefer
Elioz
E
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016208:Databases, Factual / Q000592:standards*; D004813:Epidemiology / Q000592:standards / Q000706:statistics & numerical data*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006291:Health Policy; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D007557:Israel; D007783:Lactones / Q000009:adverse effects; D015203:Reproducibility of Results; D013450:Sulfones / Q000009:adverse effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib