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I think that EBM may be a bit of a false dawn in the realm of medical malpractice/negligence. Firstly there are so many gaps in the evidence available to doctors that they will always have to use their own judgement. Secondly, although there may be evidence regarding management of a situation, the diagnosis may rely on subjective interpretation e.g. Diagnosis of fetal acidosis in labour with CTG. In my experience of Risk Management in Obstetrics, knowledge of criteria for interpretation of CTGs is not synonymous with correct interpretation and appropriate action. I do think that the sooner we move away from the situation where courts rely on partisan 'experts' and use professional bodies who create evidence-based guidelines. Paul. -- Mr Paul M Flynn MRCOG Clinical Director Obstetrics & Gynaecology, Swansea NHS Trust +44 1792 285687 Fax: +44 1792 285874 On 3/11/04 19:42, "Dean Giustini" <[log in to unmask]> wrote: > Here's a question posed today: is one answer to the complex issue of > rising medical malpractice in Canada, the United States and the UK, > broader and more meaningful adoption of the principles of EBM? > > Of course, finding the evidence is a critical part of the practice of > EBM. However, complete and flawless evidence is not enough to make valid > and valuable treatment choices. > > If the interpretation of the evidence is not logically sound or if it is > used uncritically, a patient could be harmed. Harm might also occur by a > logically flawless use of poor or poorly evaluated evidence. > > Thank you for your responses to me, offline. > > Dean Giustini, Branch Librarian > University of British Columbia > Biomedical Branch Library > Vancouver General Hospital - Heather Pavilion > Vancouver Canada > (604) 875-4505