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Re: !! ?EBM & ProgesteroneFrom: Joanne Bulley, MD (jbulley@cheshire.net)Mon May 1 13:59:15 2000
Well, at risk of whatever.... I will put in my $.02 ... Rather than WORDING it "known" benefits - I think (oops - perhaps that is an opinion) what is being said is we have no 100% PROVEN-by-EBM-benefits. As we also have no PROVEN-by-EBM way to demonstrate which pregnancy could benefit from supplementation by progesterone, we are left with EDUCATED GUESSING and in this case - there are those - both patients and docs - who will take the small risk of harm for the also small chance of benefits. Yes there are other times when the known AND unknown risks & benefits are weighed and a course of treatment is chosen (by patient and doc) where the KNOWN benefit/KNOWN risk ratio is zero. This is where informed consent comes in. The medical risk/benefit ratio of a variety of things that are done (appropriately in my opinion) is such that the medical risk outweighs the medical benefit. Should no-one be allowed to EVER spend precious resources (the patient or the insurance company or the hospital overhead) for any plastic surgery? What about breast reconstruction after breast cancer? What about vaginoplasty or dilation after radiation for endometraial cancer? Joanne
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-- Joanne Bulley, MD Keene, NH, USA
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