Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer
This paper examines the debates within medical practice as more sophisticated statistical techniques became available for evaluating the best surgical technique for the treatment of breast cancer. On the other hand, Halsted radical mastectomy advocates, accustomed to making treatment decisions based...
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| Format: | Article |
| Language: | English |
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Association of medical doctors Sanamed Novi Pazar
2012-01-01
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| Series: | Sanamed |
| Subjects: | |
| Online Access: | http://www.sanamed.rs/sanamed_pdf/sanamed_7_1/Ljiljana_Vasic.pdf |
| _version_ | 1797284233118482432 |
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| author | Vasić Ljiljana |
| author_facet | Vasić Ljiljana |
| author_sort | Vasić Ljiljana |
| collection | DOAJ |
| description | This paper examines the debates within medical practice as more sophisticated statistical techniques became available for evaluating the best surgical technique for the treatment of breast cancer. On the other hand, Halsted radical mastectomy advocates, accustomed to making treatment decisions based on personal experience, argued that randomized controlled trials would sacrifice lives to prove that they already knew. By reviewing how the critics and supporters of the randomized controlled trials attempted to prove the superiority of their methodologies, this paper demonstrates the uses of rhetoric in the construction of scientific knowledge. Radical mastectomy had also come to symbolize how surgeons acquired knowledge about therapeutic interventions. On the surface, the debates over randomized controlled trials for radical mastectomy appeared to be a sincere disagreement over competing methodologies. But the assertions of randomized controlled trials foes were inextricably linked to issues of prestige and professionalism. The impasse was finally resolved by surgeon Bernard Fisher - he had developed a biologically-based alternative that the most breast cancers spread throughout the body early in their course. Fisher’s theories explained why more aggressive local surgery appeared to have little effect on an overall survival. The combination of the multiple retrospective case studies plus his laboratory findings might have convinced Fisher that radical mastectomy was no longer necessary. Ultimately, Fisher successfully produced the type of statistical information-data from randomized controlled trials - that had become increasingly necessary to demonstrate whether or not a given therapeutic intervention had value. Exponential grow of randomized controlled trials required formulating evidence-base medicine, as a leading principle in guideline development for treatment. |
| first_indexed | 2024-03-07T17:46:12Z |
| format | Article |
| id | doaj.art-a510043784d842179b0d90003c8506d3 |
| institution | Directory Open Access Journal |
| issn | 1452-662X 2217-8171 |
| language | English |
| last_indexed | 2024-03-07T17:46:12Z |
| publishDate | 2012-01-01 |
| publisher | Association of medical doctors Sanamed Novi Pazar |
| record_format | Article |
| series | Sanamed |
| spelling | doaj.art-a510043784d842179b0d90003c8506d32024-03-02T15:01:47ZengAssociation of medical doctors Sanamed Novi PazarSanamed1452-662X2217-81712012-01-01714350Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancerVasić LjiljanaThis paper examines the debates within medical practice as more sophisticated statistical techniques became available for evaluating the best surgical technique for the treatment of breast cancer. On the other hand, Halsted radical mastectomy advocates, accustomed to making treatment decisions based on personal experience, argued that randomized controlled trials would sacrifice lives to prove that they already knew. By reviewing how the critics and supporters of the randomized controlled trials attempted to prove the superiority of their methodologies, this paper demonstrates the uses of rhetoric in the construction of scientific knowledge. Radical mastectomy had also come to symbolize how surgeons acquired knowledge about therapeutic interventions. On the surface, the debates over randomized controlled trials for radical mastectomy appeared to be a sincere disagreement over competing methodologies. But the assertions of randomized controlled trials foes were inextricably linked to issues of prestige and professionalism. The impasse was finally resolved by surgeon Bernard Fisher - he had developed a biologically-based alternative that the most breast cancers spread throughout the body early in their course. Fisher’s theories explained why more aggressive local surgery appeared to have little effect on an overall survival. The combination of the multiple retrospective case studies plus his laboratory findings might have convinced Fisher that radical mastectomy was no longer necessary. Ultimately, Fisher successfully produced the type of statistical information-data from randomized controlled trials - that had become increasingly necessary to demonstrate whether or not a given therapeutic intervention had value. Exponential grow of randomized controlled trials required formulating evidence-base medicine, as a leading principle in guideline development for treatment.http://www.sanamed.rs/sanamed_pdf/sanamed_7_1/Ljiljana_Vasic.pdfbreasttreatmentradical mastectomyrandomized controlled trialsevidence-base medicine |
| spellingShingle | Vasić Ljiljana Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer Sanamed breast treatment radical mastectomy randomized controlled trials evidence-base medicine |
| title | Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| title_full | Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| title_fullStr | Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| title_full_unstemmed | Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| title_short | Remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| title_sort | remind on struggle for introducing the controlled clinical trials to the optimal choice of surgical treatment of breast cancer |
| topic | breast treatment radical mastectomy randomized controlled trials evidence-base medicine |
| url | http://www.sanamed.rs/sanamed_pdf/sanamed_7_1/Ljiljana_Vasic.pdf |
| work_keys_str_mv | AT vasicljiljana remindonstruggleforintroducingthecontrolledclinicaltrialstotheoptimalchoiceofsurgicaltreatmentofbreastcancer |