Science is Self Correcting

February 6, 2016 Kenny Venere

Evidence based practice and a scientific approach to healthcare, while being the best we have got, has numerous shortcomings. There are issues with publication bias, conflicts of interest, fraud, outcomes switching, academic paywalls, misrepresentation of data and much more.

Skepticism: What it is and what it is not

February 2, 2016 Kenny Venere

Skepticism seems to be one of those concepts that gets a bad rap not because the actual idea or thought process is a bad one, but due to the misunderstandings and misuse of the word by those claiming to be, and those critical of, skeptics. The concept of skepticism is necessary and important in physical therapy. But first, we have to make sure we understand what skepticism is and what it is not.

Survivorship Bias and Physical Therapy

January 16, 2016 Kenny Venere

Everyone has hopefully had a “eureka” moment in the clinic— The patient no one was able to help before, who by some stroke of genius (or more likely, luck), you are able to assist in a way that is truly remarkable. These successful outcomes are likely to stick with you. They are salient, positive and downright enjoyable to think of. Our memories of positive outcomes stay with us because most of us want to be successful clinicians. So naturally, it makes sense to try and re-create what we did, or to emulate what others did to succeed. In reality though, this does not work out so well.

Poking Holes in the Evidence for Acupuncture

September 6, 2015 Kenny Venere

Throughout this entire discourse on acupuncture and needling for painful problems, Dunning et al have shown an inability or unwillingness to address central points in our argument against the effectiveness of acupuncture and needling. In addition to arriving at vastly different conclusions regarding the current trial data, Dunning and colleagues have routinely shifted the focus of the debate and presented arguments that do not relate directly to the primary issue of acupuncture’s benefits. Further, Dunning et al have consistently demonstrated a fundamental misunderstanding regarding the philosophy and implementation of evidence based practice. Their present reply is no different as they commit several critical errors in their conceptualization of evidence based practice.

Tearing Down the Pillars of Evidence Based Practice

August 11, 2015 Kenny Venere

One of the most common arguments stemming from our recent post on acupuncture, Needle in the Hay, was that we as a profession should not overly rely on “1/3rd of the pillars of evidence based practice". This argument shows nothing more than a fundamental misunderstanding of what evidence based practice is. The concepts of evidence, clinical experience/expertise and patient values do not exist independently from one another. Nor can we pick and choose which of the three best suits a particular set of beliefs. In fact, we should stop referring to evidence based practice in terms of “pillars” altogether. It is an unhelpful metaphor that only serves to perpetuate a misinterpretation of the philosophy of evidence based practice.