Evidence based diagnosis: We may need to be open to new ideas

doi:10.1136/bmj.333.7567.549

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Huw Llewelyn, consultant physician (deh.llewelyn@orange.net)

Department of Endocrinology and Diabetes, Great Western Hospital, Swindon SN3 3BB

EDITOR—If evidence based diagnosis is still in the dark ages, as Delamothe writes,1 then so is evidence based treatment. The doctor's job is to choose the right treatment. If the diagnosis is wrong then the treatment will be wrong. Inaccurate diagnoses will also affect clinical trials. A treatment may be “evidence based” because it has worked in a published study, but some patients who would have responded …