TRAVELL AND SIMONS HEART MANUAL
Feynman’s idea that ‘science is the belief in the ignorance of experts’ and Joseph Conrad ‘s that ‘Skepticism is the tonic of minds, the tonic of life, the agent of truth – the way of art and salvation’ ought to find a place with us whenever we think of fibromyalgia.ĭavid Simons, who with Janet Travell were the authors of Myofascial Pain and Dysfunction: The Trigger Point Manual (TPM), 2 was a remarkable physician. Central sensitization explains or is the primary mechanism for fibromyalgia.
There is a lot of PP-EBM in fibromyalgia. It thrives in lectures, advertising, and in some guidelines from professional organizations. Like Smith’s P-EBM, PP-EBM finds its home in journals, where citations transform it from opinion to fact. It represents assertions, ‘facts,’ definitions and beliefs that are derived without testing or without adequate scientific basis. These falsehoods, when consumed as truth by unwitting and well-intentioned practitioners of evidence-based medicine, then disseminated and adopted as routine practice, may well result not only in inappropriate quality standards and processes of care, but also in harms to patients.’īut I would suggest a second concept- ‘pseudo-pseudo evidence-based medicine (PP-EBM): disseminated ‘evidence’ that never reaches the level of evidence. Or falsehoods may result from corrupted dissemination of otherwise valid evidence. Falsehoods may result from corrupted evidence – evidence that has been suppressed, contrived from purposely biased science, or that has been manipulated and/or falsified, then published. In an important article, Wally Smith writes about ‘Pseudoevidence-based medicine.’ 1 He defines it ‘as the practice of medicine based on falsehoods that are disseminated as truth.