A Manual for Evidence-Based Clinical Practice (3rd Edition) by Gordon Guyatt, Drummond Rennie, Maureen O. Meade, Deborah J.

By Gordon Guyatt, Drummond Rennie, Maureen O. Meade, Deborah J. Cook

The best consultant to the rules and scientific purposes of evidence-based drugs.

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Extra resources for A Manual for Evidence-Based Clinical Practice (3rd Edition) (Users' Guides to the Medical Literature)

Sample text

2 This provides the philosophical basis for the second principle of EBM: not all evidence is equal (Box 3-1). In this book, we offer guidance for determining more vs less credible evidence (see Chapter 2, What Is Evidence-Based Medicine? and Chapter 23, Understanding and Applying the Results of a Systematic Review and Meta-analysis). Evidence Is Necessary but Not Sufficient for Clinical Decision Making As highlighted above, EBM has emerged as a result of our hunger for evidence or information9 to guide problem solving and decision making.

1992;268(2):240-248. Nisbett R, Ross L. Human Inference. Englewood Cliffs, NJ: Prentice-Hall; 1980. 4. Guyatt G, Sackett D, Taylor DW, Chong J, Roberts R, Pugsley S. Determining optimal therapy—randomized trials in individual patients. N Engl J Med. 1986;314(14):889-892. 5. Guyatt GH, Keller JL, Jaeschke R, Rosenbloom D, Adachi JD, Newhouse MT. The n-of-1 randomized controlled trial: clinical usefulness: our three-year experience. Ann Intern Med. 1990; 112(4):293-299. Larson EB, Ellsworth AJ, Oas J.

Why? The right side of the figure displays current reviews and textbook recommendations as data accumulated. ” Two key points: (1) at the same time, experts disagreed, and (2) it took 10 years for experts to catch up with evidence. 2 once again see widespread disagreement among the experts, most texts and reviews were recommending prophylactic lidocaine during the 2 decades during which the RCT evidence was accumulating. Why the expert disagreement, the lag behind the evidence, and the recommendations inconsistent with the evidence?

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