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Using research findings in clinical practice

BMJ 1999; 318 doi: (Published 30 January 1999) Cite this as: BMJ 1999;318:332

Doctors advocating evidence based medicine may be out of touch with real medicine

  1. John Main, Consultant physician.
  1. Renal Unit, South Cleveland Hospital, Middlesbrough TS4 3BW
  2. NHS Research and Development Centre for Evidence Based Medicine, John Radcliffe Hospital, Nuffield Department of Medicine, Oxford OX3 9DU

    EDITOR—Is it possible that the evidence based medicine lobby is so busy reviewing the literature that it has lost touch with the rather disorderly world of real medical practice? Certainly Straus and Sackett provide convincing evidence of that in their article telling us how to use research findings in practice.1 Having decided that the most important of several questions that a casualty officer could ask when faced with an alcoholic, confused man with cirrhosis who is bleeding is “Does treatment with somatostatin reduce the risk of death?”, they conclude that the answer is unknown. The correct course is therefore to form a therapeutic alliance with the patient, discuss the potential …

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