Weighing In On The Evidenced-Based Medicine Debate
- Volume 21 - Issue 7 - July 2008
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I have just finished reading the article, “EBM: Can It Be A Reality In Practice?” (see page 38 in the May issue).
I acknowledge and understand the viewpoints presented in the article.
However, if we all waited for articles to be peer reviewed before trying a new treatment, how would this help patients currently? When a new technology or modality appears, and it is presented in a journal that is not peer reviewed, should we be skeptical of using the modality on our patients?
Someone has to take the initiative to try the new product and report back to our profession on its benefits or adverse effects. Someone may write an article about a new modality that has been used 1,000 times on patients with excellent success. However, if the article is not peer reviewed, should others refrain from using the treatment described in the article?
It often takes six to 12 months to get an article accepted for publication in an indexed, peer-reviewed journal. Should the rest of the profession not use this technology or procedure until it is published in such a journal? If we all followed that logic, how would that be useful and beneficial for our patients? If a well respected podiatrist publishes an article about a new technique or procedure, should we not try and use it in our practice if it is published in Podiatry Today versus the Journal of Foot and Ankle Surgery?
Physicians need to read articles both peer-reviewed and non-peer reviewed, and make their own decisions as to whether the form of treatment would be of benefit to the patient if other methods have failed to yield a favorable response. Evidence-based medicine certainly has its place. However, one must be able to analyze information and process it to determine what would best benefit his or her patient. If we waited for everything to be evidence-based, we would not be able to offer patients some of the newest, most effective high-tech modalities.
—Steven H. Goldstein, DPM, DABPS
Royal Palm Beach, Fla.
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—John E. Fawcett, DPM
Drexel Hill, Pa.