We recently ran a guest post by Seth Roberts, detailing the case against tonsillectomies as a regularly prescribed treatment for sore throats. I was able to read Roberts' post before it went up here, and comment on it. And Roberts made several changes to the post, which I had suggested, before it ran.

In general, I'm a big fan of basing medical treatment on evidence, rather than conjecture, tradition, or mythology. And, while I have a big problem with woo-woo (shorthand for attempts at medical treatment that are based primarily on conjecture, tradition, and mythology), I do think it's important to point out that woo-woo doesn't always come from hippies. Local doctors don't always follow the evidence, either. In fact, that's one big reason why "evidence-based medicine" has to be called that, rather than just medicine. So while I didn't agree with everything Roberts had to say, I thought his key point—tonsillectomy as a treatment for sore throats isn't actually strongly supported by evidence—was a valuable one.

That said, I R NOT A MEDICAL EXPERT. And neither is Roberts. Steven Novella, however, is a medical doctor and a clinical researcher. He has a very good blog post up that points out some important flaws in Roberts post. Here's the gist of what he has to say: Roberts seems to have misunderstood some of the studies he linked to, and assigned too much importance to others. "Evidence" can mean a range of different things. Some evidence is better than others. Just because a study was published doesn't mean it's evidence worth paying attention to. And it is very easy for people to get confused by this distinction when they start trying to treat themselves with the help of Google.

For instance, Roberts provided a laundry list of potential complications of tonsillectomy and asked why the evidence-based Cochrane Review didn't talk about any of them. The problem:

He seems to take the approach of listing any possible hypothesized risk as if it is established.

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