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Thomas Huxley characterised “the great tragedy of Science” as “the slaying of a beautiful hypothesis by an ugly fact.” Unfortunately, when medical hypotheses are disproven, they act more like zombies than corpses, revived by the sorcerers of Mammon, aided and abetted by the inertia of medical practice.
Recent examples in diverse areas of clinical practice will likely suffer the problem of perseverance of beautiful but flawed hypotheses, so we are raising the alarm now. Three large trials in 2008 showed that intensive control of type 2 diabetes mellitus lacks benefits for patients and increases adverse effects1-3 (including one in this issue of Evidence-Based Medicine4), and 2 trials showed that the self-monitoring of blood sugar in type 2 diabetes is not cost-effective5 and is associated with depression.6 Two trials have documented the lack of benefits of antiviral agents for Bell palsy (while confirming the benefits of corticosteroids).7 8 Many trials and meta-analyses have confirmed and reconfirmed the absence of benefits and presence of harmful effects of antioxidants for the prevention of cancer9 10 and cardiovascular disease.11
For each of these “slayings,” vested interests will undoubtedly try to make us forget that the justification for their promotions has been gored. For type 2 diabetes, …