It is an interesting conundrum that while the objective of undertaking any research
should be to inform clinical practice in some manner, that we should then have so
much difficulty in weighing the results of such research and deciding how far it should,
or should not, guide practice. The principles of evidence-based medicine (EBM) are
now irrevocably imbedded in many health care systems throughout the world. Sackett
et al. [
[1]
] in a much-quoted article outlined what EBM “is,” and in recognizing the practicalities
involved of using such an approach, perhaps just as importantly outlined what it “isn’t.”
However, even with a cursory knowledge of EBM, it soon becomes apparent that in trying
to apply evidence generated from studies to clinical situations we are not dealing
with certainties, rather, with varying degrees of uncertainty. In many situations,
information is incomplete and decision makers must wrestle with an irreducible core
of uncertainty. How we take account of and express that uncertainty within the specific
context of care is the crux of the issue.To read this article in full you will need to make a payment
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References
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Article info
Publication history
Published online: September 02, 2011
Accepted:
November 25,
2010
Footnotes
Competing interests: The authors are Editors of Clinical Evidence. Members of the Clinical Evidence Group have at various times been involved in the GRADE Working Group although this does not include any of the present authors of this commentary.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
