Re: misleading claims about albumin.
Randomised studies which have failed to consider the confounding
influences of meme mutations and the branching meme complexes that have
evolved from them. The study of the relative benefits of balanced salt
solutions and albumin in the resucitation of patients is a good example
(1). In this case a beneficial effect of albumin might have been missed
for these very reasons (2).
The prostacyclin study published in the NEJM (3), addressed in this
eLetter to the CMAJ, is a example of what I believe to have been
unappreciated risks in the best designed and most acclaimed of prospective
randomised studis in the critically ill.
Evidence-informed medicine (4)would indeed seem to be a more
appropriate term than evidence-based medicine and certainly preferable to
meme-BM a term which by definition would have to include memes and meme
complexes that have evolved from mutated memes.
1. Misleading claims about albumin
Mahlon M. Wilkes, et al. (10 November 2004) .
2. Might saline have caused unappreciated harm in this study?
Richard G Fiddian-Green
eCMAJ, 14 Aug 2004 eLetter re: Roy Ilan and Robert A. Fowler
Should we use albumin or saline for fluid resuscitation of critically ill
CMAJ 2004; 171: 232
3. Bihari D, Smithies M, Gimson A, Tinker J. The effects of
vasodilation with prostacyclin on oxygen delivery and uptake in critically
N Engl J Med. 1987 Aug 13;317(7):397-403.
4. Evidence-Informed Practice not Meme-BM
Paul P Glasziou (4 November 2004) eLetter re: John Gabbay and Andrée le
Evidence based guidelines or collectively constructed "mindlines?"
Ethnographic study of knowledge management in primary care
BMJ 2004; 329: 1013-0
Competing interests: No competing interests