The truth in EBM in my view does not come from EBM, but it comes from its
foundation on empiricism (research) and logic (argument). However truth of
empiricism and logic does drive from themselves - these are the final ports
of call for (objective) truth.
'Subjective' individual 'truth' needs to tested again by objective truth
criteria (empiricism and logic) for it to be of use to others.
Mustafa Soomro MBBS MRCPsych
-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask]
<[log in to unmask]>
Date: Sunday, 14 January, 2001 21:06
Subject: A "little proof" for the pragmatic value of EBM
>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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