• When in doubt, maybe we should keep our mouths shut

    There’s a very thoughful piece in JAMA that was just released. It places the recent USPSTF recommendations on Vitamin D (covered here by Healthcare Triage News) in context. The gist of the history is that while lots of people have pushed Vitamin D supplementation for many years, there’s not a lot of evidence that it works. The meta-analysis doesn’t support it. But some still believe. There are some bigger and better RCTs in the works.

    But we’ve got a fair amount of evidence that pushing it isn’t supported by evidence. What do to? The authors have a response:

    When there is uncertainty about whether supplementation is warranted, the usual medical principle is to err on the side of caution and to avoid excess. Thus, while awaiting the results of the large trials now in progress, physicians would be well advised to follow current USPSTF and IOM recommendations and avoid overscreening and overprescribing supplemental vitamin D. Doing so is not only in the best interest of current patients but will also help advance knowledge to benefit future patients and inform future public health recommendations.

    When there’s doubt that what we’re doing is a good idea, maybe we should stop telling people to do it. At least, until we’re more sure. I feel like a lot of what I’ve been writing lately falls into this theme.

    @aaronecarroll

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