In a message dated 1/14/2001 9:39:58 AM Central Standard Time,
[log in to unmask] writes:
>
> Actually, ... postmodernists in medicine....have criticised EBM as being a
metanarrative, a grand truth that rests upon itself as being its own
foundation and truth.
They point out that, while EBM approaches can make one practice more
evidence-based, there is little proof that evidence-based practice benefits
patients in ways other than making their practice more evidence-based.
To Whom It May Concern....
Dr Sackett ,in correspondence exchanged several years ago did
agree with this definition of evidence-based medicine...i.e.
cited evidence, fact, truth and accurate information, when applied
to the on-going decisions made during the diagnosis and
treatment of patients is a form of "evidence-based"
medical practice.
In my situation as a radiologic diagnostician, I
read journals, abstract their truths, stated advances
and clinical advisories then install them in my
computer. As day-to-day cases are processed, my
printed notions and observations are augmented
with specific citations to the supporting literature concerning that
diagnosis or finding.
For 80,000 patient transactions processed by manual
methods (that is dictation, transcription and page-
by-page look-up of data stored in books and journals),
my case error rate was four percent.
After computing the reports, reading the available
histories carried in electric archives and then
using the machine's stored data as an "electronic
look-up" source, my error rate fell to two percent
in a subsequent 100,000 cases.
This observation is tucked away in the following
article " Solo Practice Management: Value of
a Computerized Reporting System" in the American
Journal of Roentgenology v 162: 1439-1441, June,
1994.
In summary, while proof of value for EBM is hard to
come by, there is some if you look for it.
Karl T. Dockray, MD, DABR, ABNM
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