I read the paper of Isaacs and Fitzgerald with great interest and
amusement. I am a skeptical proponent of evidence-based medicine, but
would add the definition that it is a system of belief that requires
prospectively collected objective evidence of everything except its own
utility. In the same vein as Issacs and Fitzgerald, I suggest the
adoption of the following as a realistic evidence-based rating scale:
Class 0: things I believe
Class 0a: things I believe despite the available data
Class 1: randomized, controlled clinical trials (RCCTs) that agree
with what I believe
Class 2: other prospectively collected data
Class 3: expert opinion
Class 4: RCCTs that don't agree with what I believe
Class 5: what you believe that I don't
Competing interests:
No competing interests
18 December 1999
Thomas P Bleck
Professor of Neurology, Neurological Surgery, and Internal Medicine
Rapid Response:
Evidence based medicine rating scale
I read the paper of Isaacs and Fitzgerald with great interest and
amusement. I am a skeptical proponent of evidence-based medicine, but
would add the definition that it is a system of belief that requires
prospectively collected objective evidence of everything except its own
utility. In the same vein as Issacs and Fitzgerald, I suggest the
adoption of the following as a realistic evidence-based rating scale:
Class 0: things I believe
Class 0a: things I believe despite the available data
Class 1: randomized, controlled clinical trials (RCCTs) that agree
with what I believe
Class 2: other prospectively collected data
Class 3: expert opinion
Class 4: RCCTs that don't agree with what I believe
Class 5: what you believe that I don't
Competing interests: No competing interests