In Favor of Fever

Thursday, August 19th, 2010

Robin Hanson speaks out in favor of fever:

The US spends over 17% of income, two trillion dollars a year, on medicine, mostly on new intensive treatments. You might think this was because we long ago carefully studied all the simple cheap treatments, and got as much mileage as we could from them, so now must consider complex expensive treatments. You’d be very very wrong.

One of the commonest, and cheapest, forms of medicine is “antipyretics”, e.g. aspirin, for reducing temperature. You know you are getting “modern” medicine if, when sick, people take your temperature often, and give you antipyretics when “too hot.” Seeing this care, you can relax assured you are getting modern care.

Turns out, we hardly have any data on whether this helps, and what data we do have says it probably makes you sicker, except in a few rare situations like stroke or head injury. It seems we are very reluctant to give up the appearance of helping the sick, even if our “help” probably makes them sicker.

We also seem pretty uninterested in collecting the data needed to clarify this. The biggest randomized trial to date was stopped mid-trial because “there were seven deaths in people getting standard treatment and only one in those allowed to have fever,… [so] it would be unethical to allow any more patients to get standard treatment.” Yet standard treatment continues because others say not enough trials exist to justify changing standard treatment. Is that #$@%-ed up ethics or what?

If you subscribe to New Scientist, you can read the original article he’s citing in its entirety.

(Hat tip to Aretae.)

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