REPLY
Clinical Experience and Evidence-Based Medicine
Robert G. Badgett, MD;
Mary O'Keefe, MD; and
Mark C. Henderson, MD
1 February 1998 | Volume 128 Issue 3 | Page 245
IN RESPONSE:
We completely agree that clinical experience is critical to decision making and teaching. As we stated in our abstract and paper, systematic reviews are meant not to replace clinician decision making but rather to enhance it.
We avoided stating precisely how much medical decision making should be based on systematic reviews and medical evidence as opposed to clinical experience. However, on the basis of the observation that recommendations of expert clinicians frequently contradict published medical evidence [1], we believe that many physicians rely excessively on clinical experience. Clinical experience is essential but should be complemented by evidence-based medicine in order to provide optimal patient care.
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Author and Article Information
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The University of Texas Health Science Center at San Antonio; Audie L. Murphy Veterans Administration Hospital; San Antonio, TX 78284
1. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC. A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA. 1992; 268:240-8.
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