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Dr. Hanna Saadeh

Levels of Medical Evidence

Doubting Confirmed Truths

It is the duty of science to periodically doubt its own confirmed truths and to subject them to re-examination whenever new data conflicts with old findings.  As a result of this periodic self-monitoring, old truths continue to become refined over time. 

Indeed, newer studies have now confirmed that lowering cholesterol protects against heart attacks mainly if the lowering affects the LDL (Low Density Lipoprotein) cholesterol fraction.  If the lowering affects the HDL (High Density Lipoprotein) cholesterol fraction, it may indeed encourage heart attacks.  Moreover, the same degree of lowering, when achieved by different types of medications, does not provide the same degree of protection, which means that the choice of medicine is as important as is the degree of lowering.

 

Levels of Medical Evidence

Retrospective, Observational Studies

These begin by observing a recognizable pattern of disease behavior such as—people with high blood pressures have more strokes, those with high cholesterols have more heart attacks, and those with more stress have more bleeding ulcers.  These observations provoke hypotheses or theories that attempt to explain the observed phenomena. Observers might theorize that:

a) high blood pressure—by weakening the arteries—causes strokes,

b) high cholesterol—by dirtying the arteries—causes heart attacks, and

c) stress—by increasing stomach acid—causes bleeding ulcers.

 

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