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Has reimbursement for knee osteoarthritis treatments now reached ‘postfact’ status?
  1. John Orchard1,
  2. Maarten H Moen2
  1. 1 School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2 Department of Elite sports, NOC NSF, Arnhem, Gelderland, The Netherlands
  1. Correspondence to Dr John Orchard; john.orchard{at}sydney.edu.au

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One of the words of 2016 ‘postfact’ was applied mainly to the field of politics. Many of us working in healthcare, based on science, have been concerned by the recent trend for populists to ‘choose their own facts’. But is healthcare immune to its own versions of fake news and postfact logic? And is it limited to the obvious fringe examples like the antivaccination movement?

Basis for reimbursement of procedures in health systems

Many treatments in medicine become popular based on ‘promising’ results from low-quality studies that are subsequently found to be ineffective based on multiple high-quality randomised control trials (RCTs) and their meta-analysis in systematic reviews (SRs).

While scientific publication evolves quite rapidly, funding in healthcare is very static. Funding for healthcare procedures historically appears to be based on popularity (widespread use) and expert guidelines rather than evidence based. And then, once funding for a medical procedure becomes ‘established’, the burden of evidence required to remove the funding appears to be very high. However, the …

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