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Alternativestoevidencebasedmedicine1999

Alternativestoevidencebasedmedicine1999 - Seven...

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Seven alternatives to evidence-based medicine British Medical Journal, December 18, 1999; 319(7225): 1618. David Isaacs, clinical professor and Dominic Fitzgerald, staff physician Departments of Education and Medicine, New Children's Hospital, Westmead, NSW 2145, Australia Clinical decisions should, as far as possible, be evidence based. So runs the current clinical dogma. 12 We are urged to lump all the relevant randomised controlled trials into one giant meta-analysis and come out with a combined odds ratio for all decisions. Physicians, surgeons, nurses are doing it 3 5 ; soon even the lawyers will be using evidence based practice. 6 But what if there is no evidence on which to base a clinical decision? Participants, methods, and results We, two humble clinicians ever ready for advice and guidance, asked our colleagues what they would do if faced with a clinical problem for which there are no randomised controlled trials and no good evidence. We found ourselves faced with several personality based opinions, as would be expected in a teaching hospital.
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  • Spring '09
  • Neal
  • Randomized controlled trial, British Medical Journal, The Canon of Medicine, Evidence-based medicine, clinical decisions Evidence, Eminence based medicine

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