Ditto Kev "Don't associate EBP with poor recommendations - leave that to
our detractors"
In response to Michael's question "Is there a place for common sense in
EBM", I find Voltaire's notion that "Common sense is not so common"
coming to mind.
Having been a nurse since the 1970s, I have seen a number of nursing
(and medical) practices, supposedly based on "common sense",
subsequently be shown to be ineffective (or even harmful).
In my experience the challenge is to change the culture of clinical
practice away from 'routine and ritual'. Sorry Michael - I don't see
so-called 'EBM-speak' as being a major issue.
Judith Finn
Professor of Nursing Research / Clinical Epidemiologist
University of Western Australia / Sir Charles Gairdner Hospital
[log in to unmask]
-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of k.hopayian
Sent: Thursday, 25 October 2007 4:47 PM
To: [log in to unmask]
Subject: Re: Is there a place for common sense in EBM?
Well done, Michael Power!
There is something in what you say but I am not sure that I would call
these
examples of EB speak. I remember seeing stuff like this when I
qualified,
more than 2 decades ago.
Don't associate EBP with poor recommendations - leave that to our
detractors
:-)
B/W, Kev Hopayian
-------on 23/10/07 09:50, Michael Power at [log in to unmask]
wrote:
> Does EBM-speak endanger common sense?
>
> Example 1.
> "Use a 21-guage needle (green) in women who weigh more than 90kg."
>
> This recommendation is appropriate for a brainless robot.
> In plain English, the common sense recommendation for a thinking human
> would be "Use an adequately long needle if you have to give an
> intramuscular injection through a thick layer of adipose tissue."
>
> Example 2.
> "We don't know if other osmotic laxatives such as magnesium salts , or
> phosphate or sodium citrate enemas are effective."
>
> There is a simple cure for this piece of ignorance: take a dose of
epsom
> salts and see what happens. Or, submit a grant application for a
> doubleblind, placebo controlled RCT.
>
> Example 3.
> "Macrogol 3350 26 g daily was significantly more effective than
> 20 g lactulose daily".
>
> In practice, the dose of a laxative is adjusted to achieve the desired
> effect. So, comparing fixed doses of different laxatives provides
> information that is more likely to be useful for marketing than for
the
> patient or practitioner. Most of the evidence on laxatives is at this
> level.
>
> If you have any other examples where common sense has been sacrificed
to
> the form of EBM-speak, please send them to me. I am building a
collection.
>
> Thoughts on the aetiology and treatment of hypocommonsentia would also
be
> welcome.
>
> Michael Power
> Clinical Knowledge Author, Guideline Developer and Informatician
> Clinical Knowledge Summaries Service www.cks.library.nhs.uk
> Sowerby Centre for Health Informatics at Newcastle Ltd www.schin.co.uk
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