Personal knowledge

doi:10.1136/bmj.332.7534.129

BMJ 2006;332:129-130 (21 January), doi:10.1136/bmj.332.7534.129

Editorial

Personal knowledge

Doctors are much more than simple conduits for clinical evidence

The first 150 words of the full text of this article appear below.

Choudry and colleagues' paper in this issue (p 141) is a braveattempt to quantify the under-recognised notion of personalknowledge in clinical practice.^{1 2} They carefully analysed theprescribing decisions of hospital doctors caring for patientswith atrial fibrillation, before and after their exposure toa patient with an adverse event—either serious haemorrhagewhen taking warfarin, or a thromboembolic event while not takingwarfarin. The researchers wanted to know whether doctors' knowledgeof a previous adverse event affected their subsequent prescribing.

For the group of doctors who were exposed to patients with adversebleeding events, and who cared for atrial fibrillation patientssubsequently, the odds that they would prescribe warfarin were21% lower for subsequent patients. There was no statisticallysignificant change in warfarin prescribing after a doctor caredfor a patient who had had a stroke while not taking warfarin,nor—in support of the specificity of . . . [Full text of this article]

Kieran Sweeney, honorary clinical senior lecturer in general practice

Peninsula Medical School, Exeter EX2 5DW
(kieran.sweeney@pms.ac.uk)

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