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Whereas, reading the results of meta analysis on an unresolved clinical
problem, or collecting evidence based data is well and good, however,
clinical medicine through its history relied on clinical experience and
the well founded medical knowledge of the physician. In many clinical
situations the physician has to take the best course of action for his
patient and more often than not cannot wait for the results of the meta
analysis. Some times the latter is redundant.
As an observer, evidence based data is really not crucial in solving a
problem. To wit, a patient in the intensive care unit, airway intubated,
and with a nasogastric feeding tube and a foley catheter in his bladder
and swan ganz catheter, I do not need a meta analysis to inform me that
the patient is prone to aspiration pneumonia, or urinary tract infection
or bacteremia. A recent article in the Annals of Internal medicine {October
17, 2006} entitled "Device-Associated Nosocomial Infections in..." {in
several thousand patients}
in 8 developing countries' ICUs, proves my point. The obvious is quite
obvious.
Individualizing each clinical problem of patients many times obviates waiting
for remote statistical percentages.
physician waiting before action, pending evidence or meta analysis
Whereas, reading the results of meta analysis on an unresolved clinical
problem, or collecting evidence based data is well and good, however,
clinical medicine through its history relied on clinical experience and
the well founded medical knowledge of the physician. In many clinical
situations the physician has to take the best course of action for his
patient and more often than not cannot wait for the results of the meta
analysis. Some times the latter is redundant.
As an observer, evidence based data is really not crucial in solving a
problem. To wit, a patient in the intensive care unit, airway intubated,
and with a nasogastric feeding tube and a foley catheter in his bladder
and swan ganz catheter, I do not need a meta analysis to inform me that
the patient is prone to aspiration pneumonia, or urinary tract infection
or bacteremia. A recent article in the Annals of Internal medicine {October
17, 2006} entitled "Device-Associated Nosocomial Infections in..." {in
several thousand patients}
in 8 developing countries' ICUs, proves my point. The obvious is quite
obvious.
Individualizing each clinical problem of patients many times obviates waiting
for remote statistical percentages.
Competing interests:
None declared
Competing interests: No competing interests