Problems
in the "Evidence"
of "Evidence-Based Medicine"
◊ The results show comparative
efficacy of treatment for an "average"
randomized patient, not for pertinent subgroups
formed by such cogent
clinical features as severity of symptoms,
illness, co-morbidity, and other
clinical nuances.
◊ The data do not include many types of treatments or patients seen
in clinical practice.
◊ The authoritative aura may lead to major abuses that produce
inappropriate guidelines or doctrinaire
dogmas for clinical practice.
Feinstein AR & Horwitz RI:
AM J Med 1997; 103: 529-535
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