David Isaacs & Dominic Fitzgerald
Seven alternatives to evidence based medicine
BMJ, 1999, 319 (7225), 1618
Clinical decisions should, as far as possible, be evidence based. So runs the current clinical dogma. 1 2 We are urged to lump all the relevant randomised controlled trials into one giant meta-analysis and come out with a combined odds ratio for all decisions. Physicians, surgeons, nurses are doing it3-5; soon even the lawyers will be using evidence based practice.6 But what if there is no evidence on which to base a clinical decision?
