Scientific Evidence vs. Science (part II)

evidencia científica vs ciencia

Do you use these expressions? «The Scientific Evidence on a given topic says that…», «There is a lack of Scientific Evidence to show that…», «More Scientific Evidence is needed to clarify the effects of…», «More Science is needed to better understand the effects of….»

Taking into account that each patient is different due to their experiences, trauma, surgical interventions, etc., I think it is necessary to clarify the concepts of Scientific Evidence and Science in Physiotherapy.

In order to provide scientific evidence, research must be carried out with reproducibility and isolation. Let us remember that, by definition, evidence indicates a manifest certainty that is undeniable and that cannot be doubted and does not admit of discussion.

Let us give an example: if it is said that the person sitting on the stretcher is alive and that the stretcher has no life, that is something evident, no one can doubt that statement so it is evidence. Now, you can calculate the number of sample needed using the scientific method and perform an electrocardiogram on the people and stretchers needed for science to prove the evidence described above, then calling it Scientific Evidence.

Considering this reasoning and that the conclusions of much of the published research using the scientific method in areas of research where palpation is necessary to obtain results, such results do not convince 100% of the readers, I think it is more reasonable to say that it is performed Ciencia and not scientific evidence.

In basic medicine, it is possible to isolate a neuron and reproduce the stimulus that is produced, so that, under the same conditions, the result will always be the same and will be concluded in the same way, calling this scientific procedure, scientific evidence. The best scientific journals, where the most evidence is published, are those with the highest impact. In medicine, in the area of oncology, the first journal to appear has an impact of 187,040. The journal with the highest impact factor in the area of rehabilitation has 4.107. In the nursing area, the highest impact is 3,755. Scientists in any discipline try to publish in journals with the highest possible impact.

Being in a clinical health sector, touching the patient is necessary to improve the patient’s symptoms. Clinicians prioritize obtaining results to reduce or eliminate pain and normalize patients’ symptoms. For this reason, the clinic provides science with the study objectives and science is in charge of trying to protocolize in a reproducible way and, if possible, with an isolable treatment in order to explain the clinical findings and obtain conclusions using the scientific method.

In recent years, many articles have been published on techniques, mobilizations, therapies, protocols, etc. We must think that before the first scientific publication, therapies were already being used and many people doubted them because they did not have published scientific articles. Now with scientific publications, fewer people are questioning them, so research should continue and the results should be published to help clarify new unknowns. This process is an infinite process since new questions arise after each investigation.

For this reason, the best way to improve and advance in the healthcare field is to have one foot in research and the other in the clinic, trying not to bias questions and answers.

«Normalize the findings and do not treat the patient’s symptoms. Difficult for many to understand, but this is the reason for clinical «magic». How beautiful is Physiotherapy!«

Francisco Selva PT, PhD.

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