29 October 2008

The myth of "Health"

Two notes from the same press conference complement each other. And they do not add optimism at all.

Egor Vinogradov, DW-WORLD.DEExperts: Russian medicine is far from people

Russian medicine is standing still, experts of the Society of Evidence-based Medicine Specialists believe. 80 percent of doctors in Russia today are people who do not know anything and do not want to know about modern methods of treatment.

The national project "Health" is a myth. According to the experts of the Society of Evidence-based Medicine Specialists, there is no special program to improve the level of healthcare in Russia. There are several disparate government resolutions, which, however, do not change the existing approaches to the treatment of patients in the healthcare system.

Meanwhile, experts of the Society consider the situation in Russian medicine to be catastrophic. The vast majority of doctors cannot be called specialists today," said Kirill Danishevsky, president of the Society of Evidence–Based Medicine Specialists.

A doctor who does not read cannot be considered a doctor "80 percent of Russian doctors are unqualified readers, that is, they cannot even critically evaluate information.

At best, the doctor has one old textbook from 1967, which he has been using since graduation," Kirill Danishevsky cites the research data. Moreover, he points out, doctors have no incentive to improve their clinical practice. Everyone is treated with old and the same medicines, and receiving remuneration from the pharmaceutical industry. So why really dig into which drug is now considered the first choice drug in the world, the expert asks

However, doctors in Russia, one can say, have nothing to read. Firstly, there are practically no new domestic developments in the field of medicine. Secondly, those studies that are being conducted are either of an extremely low level, or their results are "paid for" in advance by the customer. Finally, what eventually comes to print is, as a rule, not scientific work, says Kirill Danishevsky.

"The basis of science in general in the world is publication in scientific journals. A researcher is evaluated by how many publications and in which journals he has," states Danishevsky. What is happening in Russia? Here, magazines are published mainly by acquaintance, the expert believes. It is necessary to write a letter to the editor-in-chief with a request for publication, and the issue is resolved. Very often people pay for publication if it is needed or just to speed up the process. And the usual channel – the movement of publications by gravity, as it does not work all over the world.

In violation of the Hippocratic Oath At the level of patients, the system of blat also mainly works.

Good Western drugs are sold only to their people from under the floor. The high technologies that the current leadership of the country is guided by are available only to "their own people". Yes, and science is far from the people. According to experts, for example, when studying diabetes, only 18 percent of studies concerned topics important to patients. "Until now, Russia is trying to eradicate the disease, instead of helping a person," says the vice–president of the society, Saveli Baschinsky.

In many Western countries, a doctor is a kind of source of information, believing that after a person is informed of the necessary minimum, the patient will be able to make an independent decision. "We don't have such a relationship in medicine," Baschinsky points out. – Why else do I think that autonomy is needed, because the ability to make an independent decision about your health is in itself an indicator of health." In addition, patients lead completely different lifestyles, and doctors in Russia, in general, have never been interested in this.

However, it is also useless to apply Western schemes, experts are sure. Their own research proves that life expectancy when using British methods of treatment increases by only one and a half years, while in the homeland of the authors of the method live 15 years longer. 90 percent of success is a change in the general social status of citizens, – experts of the Society of Evidence–based Medicine Specialists say. And here even high-class doctors are powerless.

Irina Alexandrova, ГАЗЕТА.GZT.RUScientific cover

The contribution of Russian doctors to world science is minimal.

The disappointing results of a study by experts in the field of evidence-based medicine, presented yesterday at an Independent Press Center, are published in the international journal Emerging Themes in Epidemiology. It follows from them that the world medicine does not take seriously the research conducted in Russia.

Only 2-3% of articles by Russian doctors are published in scientific and medical international journals. The contribution of Russian physicists or mathematicians to world science looks much more impressive. According to the researchers, this fact reflects the interest in the last two sciences of the defense industries.

"Scientific databases are weak in Russia, the national medical library has been transferred to the Sechenov MMA, it does not have mobile access to information," said Vasily Vlasov, one of the authors of the study, vice–president of the Society of Evidence-Based Medicine Specialists. – Domestic research is methodically extremely weak, under pressure from business, publications are often biased."

Among the reasons for what is happening, the expert noted the imperfection of legislation, which, for example, allows only manufacturing companies to research drugs, as well as primitive bureaucratic management of science, corruption and a complete lack of financial support for researchers.

The head of the Department of the Research Institute of Psychiatry of the Ministry of Health and Social Development, Alexander Nemtsov, also attributed widespread distortions of statistical medical data for political reasons to negative factors, calling them "epidemic lies" in the field of narcology, alcoholism and injuries. "As it was proved in the dissertation, which was defended in 2008 by an employee of Rosgosstat, in fact, mortality from these causes in Russia is one and a half times higher," he said.

According to the second author of the study, Kirill Danishevsky, president of the Society of Evidence–based Medicine Specialists, the best database on the citation of medical research Medline rarely cites the statements of Russian scientists, scientific Russian journals publish articles not based on the results of peer review, as it happens in the West, but by acquaintance. "It is necessary that the funding of research groups be tied to the number and level of publications in international peer–reviewed journals," the expert noted.

The publisher and ex-president of the Society of Evidence-Based Medicine Specialists, Savely Baschinsky, noted that today 80% of Russian doctors are unqualified readers of scientific journals: they do not know foreign languages, they do not introduce scientific achievements into their practice.

Portal "Eternal youth" www.vechnayamolodost.ru29.10.2008

Found a typo? Select it and press ctrl + enter Print version