Biomedical science limitations and flaws: why not choose wisely?

Abstract

Biomedical science is experiencing a reassessment of its practices of healthcare management where more appropriate cost-benefit profiles are being combined with improvements in knowledge, effectiveness, and safety of diagnostic/therapeutic procedures to drive the advances in medicine. This review aims to assess: (a) possible biases of the scientific literature and research, (b) the clinical value and the cost-effectiveness of the principal medical practices and (c) the possible contribution of integrative and translational medicine. Literature shows that current medical research has cognitive (mostly industry-induced) biases that negatively impact clinical practice: the ever-increasing use of drugs and technologies, united with a certain inattention to the basic mechanisms of pathophysiology are paving the way of reductionism in medical practice. A critical view of innovations in medicine, together with a sound understanding and application of the scientific method, would improve the effectiveness, safety and sustainability of therapies. Translational and integrative medicine can contribute to develop a new patient-centered approach. Conversely, reductionism, eminence/reimbursement-based medical decisions, lack of patient education, industry-influenced science, and limited awareness from physicians may compromise the efficacy, safety, appropriateness, and cost-effectiveness of diagnostic and therapeutic processes.