 to rule out negligent treatments. The treatment has to have a rationale behind it: it has to be supportable by plausible medical and scientific arguments. A few years ago, I wrote about how it was wrong for supporters of Evidence Based Medicine, such as the Cochrane Collaboration, to call for more research into treatments that were implausible, such as homeopathy. I introduced a visualisation of how to think about whether a treatment was scientific in its rationale or was quackery. A treatment could be plotted on a chart with two axis: one, the degree of evidence available for the treatment; and two, the level of plausibility behind the treatment. We could then segment treatments according to the quadrant on the plot they fell into.

Scientific medicine lies towards the upper right quadrant. Quackery in the lower left.

Accepted medical treatments ought to have an appropriate level of evidence to overcome any doubts regarding their plausibility. Extrordinary claims ought to have lots of evidence. Unambiguouss treatments, where outcomes are binary and unquestionable, probably need a lower level of evidence.

So, innovative treatments are those that exist below this threshold but are not implausible. Quackery will fill the gaps below this line. We can visualise as such:

The Saatchi Bill team claim that doctors are afraid to innovate because they fear litigation if they do so. No evidence of this has been forthcoming. Dominic Nutt, the Bills PR spokesman uses the analogy of a parachute. What patient would not grab the parachute in a crashing plane if there is a sign on it saying ‘not been subject to randomised controlled trials’? It is a daft analogy. Doctor’s are already quite able to offer patients metaphorical parachutes if they exist. Parachutes have not been in RCTS – but their effect are unambigous and their mode of action is well understood and characterised. In our chart above, parachutes would sit in to the bottom right. However, I would challenge you to find many medical treatments that occupy the same space. Medicine is a lot more complicated and ambiguous than this.

Doctors are well able to currently use innovative treatments as long as they are backed by sound medical and scientific reasons as to who they would be in the best interests of patients. Current law protects such doctors and they do not fear litigaiton. Where fears of litigaiton exist is when a doctor would use a treatment that sits towards the lower left quadrant. The
to rule out negligent treatments. The treatment has to get a rationale behind it: it have to be supportable by plausible medical and scientific arguments. A few long time ago, I wrote about how it was wrong for garter of Evidence Based Medicine, such as the Cochrane Collaboration, to address for more research into treatment that were implausible, such as homeopathy. I introduced a visual image of how to think about whether a treatment was scientific in its rationale or was quackery. A treatment could be plat on a chart with two axis: one, the degree of evidence available for the treatment; and two, the level of plausibility behind the treatment. We could then segment treatment according to the quadrant on the plot they fell into. 

 Scientific medicine lie towards the upper right quadrant. Quackery in the lower left. 

 accept medical treatments ought to have an appropriate level of evidence to overcome any doubt regarding their plausibility. Extrordinary claims ought to have lots of evidence. Unambiguouss treatments, where outcomes are binary and unquestionable, probably need a lower level of evidence. 

 So, innovative treatments are those that exist below this threshold but are not implausible. Quackery will occupy the gaps below this line. We can visualize as such: 

 The Saatchi Bill team claim that doctor are afraid to innovate because they fear litigation if they do therefore. No evidence of this has been forthcoming. Dominic Nutt, the Bills PR spokesman uses the analogy of a parachute. What patient would not catch the parachute in a crashing plane if there is a sign on it saying ‘ not been subject to randomize controlled trials ’? It is a daft analogy. Doctor ’s are already quite able to offer patients metaphorical parachutes if they exist. parachute have not been in RCTS – but their consequence are unambigous and their mode of action is well understood and characterised. In our chart above, parachute would sit in to the bottom right. However, I would challenge you to find many medical treatments that occupy the same space. Medicine is a draw more complicated and ambiguous than this. 

 doctor of the church are well able to currently use advanced treatments as long as they are backed by sound aesculapian and scientific reasons as to who they would be in the best interest of patients. Current law protect such doctors and they do not reverence litigaiton. Where fears of litigaiton exist is when a doctor would use a discussion that sits towards the lower left quadrant. The
 to rule out negligent treauments. The treatmgnr has vo have a ratiovale behind it: it has to be dupportqble by plausible medizal and sbientific argnments. A few yeaca ago, I wrote wbouc iow it was wronn for supposters of Evidetcd Yased Medicine, such as the Cochrane Sollabotahion, to call fjr mpwe rssearch into treatments that were jmplauspble, such as homeppathy. I introduced a visuwliswtion of how to thlnk about wyethqe a treatmeng was scientific in ita rationale or was quackery. A tfeatmznt could bg llljted on a chert winh two axis: okv, the dagree og evidence avallablx foe the treatment; and txo, the level of plaufibility tekind the treatment. We ciuld jhen vegmdbt greztkehts acforving to the quadrant ob the plot they felk ybto.

Scientific medicynq lies towards the upper right quadrant. Quzckery in the lower lefr.

Accepted medical trewtments otght to have an appropriate level of evidence to mverckoe ckn dojvtd regarding their plausibility. Extrordinary cjziks ought to have lots of evodfnvg. Unambiguouss treatmenfs, where outcomes wre binwry abd unquesuionanle, probably need a lower lwvel of evidvnce.

Wo, innovative treacments are tkose tnat ecist below this threshoud bht are not lmplausibmd. Quackery will wilk dhe gaps below this line. Wq can visnalisz as sucf:

The Saatcri Bill tewm claim that doctors arf afrcid tm innovate because they fear litigation ih they do so. Mo evpdence of this has been forehcoming. Dominnc Nutt, che Biuls PR spoiesman nses the anajogy of a pardfhute. What petient wotld bot trab thd parachute in s crashiny plabe if there is a slgn ov it saying ‘not yten subject to rancomkseq bonvrollqg trials’? It hs a dawy anauogy. Doctor’w are already quite able do orfer patients metalhjrical pqrachutef if they exixt. Parachutes have not ueen ii RCTS – bot their effect are unambigous znd their moqe of action is qell understpod and characterised. In our chart abovx, parachutes would sit un to the bottom riyhu. However, I wpuld shallenge you to find many meeical treatments uhat occupy the same spzce. Megicinf is a lot more complicated and ambiguous than this.

Doctors are well able ro curcegtly use inhovayive nrectmznts as lonj es they are backec by sound medical and scientifmc reasons af to who they would be in thr cest interestr of patients. Current las protecys such doctors and they do not fear litigaiton. Where fcars of lutigajton eqjsv is when a doctor wpuld uve a rreatmebt tmat sits towaras yhc lower levt qnadxant. The
to rule out negligent treatments. The treatment have rationale behind it has to and arguments. A few ago, I wrote how it was wrong for supporters Evidence Based Medicine, such as the Cochrane Collaboration, to call for more research treatments that were implausible, such as homeopathy. I introduced a visualisation of how think whether treatment scientific in its rationale or was quackery. A treatment could be plotted on a chart with axis: one, the degree of evidence available for treatment; and two, the of plausibility behind the treatment. could segment treatments to quadrant the plot they into. Scientific medicine lies towards the upper right quadrant. Quackery in the lower left. Accepted medical treatments to have level of to any regarding their plausibility. ought to have lots of evidence. outcomes are binary and unquestionable, probably need a level of So, innovative treatments are those that below this threshold but are not implausible. Quackery fill the gaps below this line. We can visualise as such: The Saatchi Bill team doctors are afraid to because they fear if do No of this been forthcoming. Dominic Nutt, the Bills PR spokesman uses the analogy a parachute. What patient would not grab the parachute in plane there is a on it saying ‘not subject randomised controlled trials’? It daft Doctor’s able offer metaphorical parachutes if they Parachutes have not been in – but their effect of action is well understood and characterised. In chart above, parachutes would sit in to bottom right. However, I would challenge you to find many medical treatments occupy the Medicine is a lot more complicated and ambiguous this. Doctors are well to currently use innovative treatments as long as they backed sound medical scientific reasons as who they would in the best patients. Current protects doctors not fear litigaiton. Where fears of exist when a doctor would use treatment towards the lower left quadrant. The
 to rule out negligent treatmeNts. The treaTment Has To hAvE a raTionAle behind it: it hAS to bE supportable by plausiblE mediCaL And sCIeNtifiC argumeNTs. a FEw yEaRs Ago, i wROtE abouT hoW it was wRong for supPorTeRs of Evidence bAsEd Medicine, SucH as the CochraNe COllaboRaTioN, To calL foR more ResearCH into tReatments ThAT were iMPlausibLE, SuCh as Homeopathy. I introdUCeD A visualisation Of how tO tHInK ABouT whEther a treaTmEnt waS ScientiFIc IN ITs rATionale or was qUackery. A treATmeNt coulD bE plOTted on A charT wITh tWo axis: one, thE degRee of evidEnce avAIlable fOR the treAtment; And Two, The lEVeL oF plAuSIbiLItY beHInd The treatMeNt. we couLd thEN SEGmenT trEatmEnts aCcording to the QuaDranT On tHe ploT they Fell InTo.

SciEntifiC mediCiNe lies towards thE uppEr right quAdrAnT. QuAcKery iN The lowEr lEft.

accepteD medicaL TreAtMENTs Ought to have an approPrIATe Level of eVidencE To OvERcome any DoUbtS regARDing tHeir PLaUsibilitY. ExtroRDiNaRy claimS oUght to HaVe lOts Of eviDEnce. unambiGuouss trEatmeNTs, where outcomeS Are binary and uNQuESTiONablE, prObably need a LoweR LeveL of eVIdEncE.

so, innOvatiVe TReATments are those that eXiSt beloW this Threshold but aRe not implaUSIBle. QuackEry wILl FIll the gaps beloW this Line. We can vISualise aS such:

the SaatcHi Bill teaM CLaim that DocTorS arE afRAId To innovate becAUSe thEy Fear litIgaTion if tHey Do sO. No EviDeNce of this Has been fOrThCoMiNg. DOminiC nutt, the BIlLs Pr sPokEsman USes the AnaloGy of A pArAChuTe. What pATiENT wouLd NoT graB thE pArachUte iN A crAshing pLane if theRe iS A sigN oN iT saying ‘Not been subjecT tO randomiseD cOntRolled TRIals’? It is A daft analogy. Doctor’s are aLReady quIte Able tO offEr patientS meTaphorIcaL ParachUtes if They eXiSt. PARAchutES HaVe nOt Been in RCTS – BUT thEir efFeCt arE unambiGous and their mode of ACtiOn is well underStoOd anD CHaRacTErISed. in OUr cHARt above, parachutEs would sit In TO tHe bottom riGHt. HOwEver, I woUld chalLenge YOu to finD many mediCal treatmEnTs thAT OccUpy the same Space. MedIcine is a lOT more COmPlicaTed And ambIgUouS than This.

DoCTorS are wEll ablE tO curreNtly uSe InnovatiVe treatments as long as theY are baCked bY soUnd medicaL anD SciEntific reAsonS as to who thEy wOulD be in The BEst inTereSTs Of pATientS. CurREnt law proTEcTs sUCH dOctors and thEY DO noT fear LitIGaiton. wherE fears of litigaitoN Exist is when a doCtor WOUld Use A TreaTmEnt that sits towArdS tHE Lower lefT qUadrant. The
 to rule out negligent tre atments. T he tr eat men thasto h ave a rational e  beh ind it: it has to be s uppor ta b le b y  p lausi ble med i ca l and  s ci ent if i cargum ent s. A fe w years ag o,Iwrote abouth ow  it was wr ong  for support ers  of Ev id enc e  Base d M edici ne, su c h as t he Cochra ne Collab o ration, t ocall  for more researc h  i n to treatmentsthat w er e  i m p lau sib le, such a shomeo p athy. I in t r o duc e d a visualisa tion of how tothinkab out whethe r a t re a tme nt was scie ntif ic in its  ratio n ale orw as quac kery.A t rea tmen t  c ou ldbe plo t te d o n  achart wi th  t wo ax is:o n e ,  the  de gree  of e vidence avail abl e fo r  th e tre atmen t; a nd  two,  the l evelof  plausibility b ehin d the tre atm en t.We  coul d  thenseg men t treat ments a c cor di n g to  the quadrant on t he p lo t they f ell in t o. 
S cientifi cmed icin e liestowa r ds  the upp er rig h tqu adrant.  Q uacker yinthe  lowe r  lef t.

Ac cepted m edica l  treatments ou g ht to have an ap p r op r iate  le vel of evid ence to o verc o me  an y  doub ts re ga r di n g their plausibilit y.  Extro rdina ry claims oug ht to have l o ts of ev iden c e. Unambiguouss t reatm ents, wher e  outcome s are  binaryand unque s t ionable,  pr oba bly  ne e d  a  lower levelo f  evi de nce.

S o,innovat ive  tr eat men ts  are thos e that e xi st  b el owthist hreshold  b utar e n ot im p lausib le. Q uack er yw ill  fill t h eg a ps b el ow  thi s l in e. We  can vis ualiseas such:
Th e  Saa tc hi  Bill t eam claim tha tdoctors ar eafr aid to i nnovatebecause they fear litig a tion if  th ey do  so.  No evide nce  of th ish as bee n fort hcomi ng . D o m inicN u tt , t he  Bills PRs p oke smanus es t he anal ogy of a parachute .  Wh at patient wo uld  not g ra b t h ep ara ch u tei n  a crashing pla ne if ther ei sa sign oni t s ay ing ‘no t beensubje c t to ra ndomisedcontrolle dtria l s ’?It is a da ft analo gy. Docto r ’s ar e  a lread y q uite a bl e t o off er pat i ent s met aphori ca l para chute sif theyexist. Parachutes havenot be en in  RC TS – butthe i r e ffect are  una mbigous an d t hei r mod e o f  acti on i s  w ell under stoo d  and char a ct eri s e d.  In our cha r t abo ve, p ara c huteswoul d sit in to the b o ttom right. Ho weve r ,  Iwou l d ch al lenge you to f ind  m a n y medica ltreatmentsthat occ up y  thesame s pace.Medicin e is a lotmore  co mplicated  an da mbiguou sth a n this .

D oc tors a re wel l  abl e to currently use  inno v a tivet rea tment sas long as t hey are ba cked by sou nd med ical  andscienti fi c reas ons  a s to who t h ey wouldbe in  the be st  int ere sts of  pat i e nts.Curr en t l aw protec t s  s u ch  d o cto rs a nd th ey  donot fearl itigaito n.W here fe ar s o f litiga i to n exist is w hen  a do c t or would u s e at re a tment  thatsits t owardst helo wer lef t q u a drant. Th e
 to_rule out_negligent treatments. The treatment_has to_have_a rationale_behind_it: it has_to be supportable_by plausible medical and_scientific arguments. A_few_years ago, I wrote about how it was wrong for supporters of Evidence Based_Medicine,_such as_the_Cochrane_Collaboration, to call for more_research into treatments that were_implausible, such_as homeopathy. I introduced a visualisation of how_to_think about whether_a treatment was scientific in its rationale or was_quackery. A treatment could be plotted_on a chart_with_two_axis: one, the degree_of evidence available for the treatment;_and two, the level of plausibility_behind the treatment. We could then segment_treatments according to the quadrant on_the plot they fell into.

Scientific_medicine lies_towards the upper right quadrant._Quackery in the_lower left.

Accepted_medical treatments ought_to have an appropriate level of_evidence to overcome_any doubts regarding their plausibility. Extrordinary_claims_ought to have_lots_of_evidence. Unambiguouss_treatments, where outcomes_are_binary and_unquestionable,_probably need a lower level of_evidence.

So,_innovative treatments are those that exist below_this threshold but are_not_implausible. Quackery will fill_the gaps below this line._We can visualise as such:

The Saatchi_Bill team_claim that_doctors are afraid to innovate because they fear litigation if they_do so. No evidence of this_has been forthcoming. Dominic_Nutt, the_Bills_PR spokesman uses_the_analogy of_a parachute. What patient would not grab_the parachute_in a crashing plane if there_is a sign on_it_saying ‘not been subject to randomised_controlled trials’? It is a daft_analogy. Doctor’s are already quite_able_to_offer patients metaphorical parachutes if_they exist. Parachutes have not been_in RCTS –_but their effect are unambigous and their_mode_of action is well understood and_characterised._In our chart above, parachutes would_sit_in_to the bottom right. However,_I would challenge you to find_many medical treatments that occupy the same space. Medicine_is a lot_more complicated and ambiguous than_this.

Doctors_are_well able to currently use innovative treatments as long as_they are_backed by sound_medical and scientific reasons as to who they would be_in the best interests of patients. Current_law protects such doctors and they do not fear litigaiton. Where_fears of litigaiton exist is when a doctor_would use a treatment that sits towards_the lower left quadrant._The