Evidence based medicine means prescribing and diagnosing based on statistics. You diagnose based on evidence for a disease, and prescribe based on what will give your patient’s the greatest probability of a successful relapse of symptoms. There is evidence for PFS in literature. It may not be clear cut, defined, or understood, but papers out there address the psychological, cognitive, and sexual symptoms we are facing. This is considered “level 3/4 evidence” which IS a form of evidence, but not a strong one. Anecdotes are even lower forms of evidence, and they are level 5 pieces of evidence. I truly believe that one day, the real mechanism behind our symptoms will be elucidated, via RCTs, or discovering the molecular mechanism which would be the highest form of evidence.
What I’m getting at is that we do have evidence of PFS right now, and doctors should acknowledge that. In the future, I believe we’ll have stronger evidence and doctors WILL acknowledge that.
I know we got absolutely fucked by big pharm, but I don’t think many clinical trials are manipulated. I think the FDA is actually really strict in allowing what gets through to the market. We’re one of the unlucky ones that had side effects that passed through in clinical trials.
Less than 10% of drugs that make it to the human testing stage (and not many drugs make it that far) get to the market.