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Seven alternatives to evidence based medicine

1999; BMJ; Volume: 319; Issue: 7225 Linguagem: Inglês

10.1136/bmj.319.7225.1618

0959-8138

David Isaacs, Dominic A. Fitzgerald,

Meta-analysis and systematic reviews

Clinical decisions should, as far as possible, be evidence based.So runs the current clinical dogma. 1 2 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. 6But what if there is no evidence on which to base a clinical decision?