Moderation Rules

New technology and science make numerous dreams feasible. But it takes us long to realize that the spectacle of high-tech science does not necessarily make life easier.

"We won’t have long to wait to find out this," I told myself after my preparation of the teaching material for an intensive review course for doctors sitting for examination.

At a glance of recent medical literature, the rule of moderation strikes me. As a matter of fact, the title of this blog can be read either in the straightforward sense of "rules about moderation" or in the graffiti sense of "moderation rules!"

For example, two recently published compilations of clinical trial data — called meta-analyses — tell us that normalizing the haemoglobin levels of our anaemic patients with kidney failure or cancer by the high-tech anaemia drugs can hasten their death, instead of doing them good. I was soon reminded of recent evidence that liberal blood transfusion actually do more harms than benefits in critically ill patients with low haemoglobin levels. Low haemoglobin level has been thought to be dangerous, but pushing it high might not be wise, either.

What next? We are then taken aback by the recent news that a big clinical trial was halted prematurely when a startling increased risk for death was noted among diabetic patients who were assigned to intensive glucose-lowering therapy.

So. What have we learnt? The close resemblance of this moderation rule from clinical trials performed virtually everywhere on this planet is striking. To me that sounds convincing. But, I simply wonder if we should apply the same moderation rule to our kids who are nowadays caught up in an endless race of extra tuition sessions, tennis classes, piano lessons, French courses - and the list goes on.