A recent paper in the BMJ sets up a false opposition between EBP and the
consideration of patient values and beliefs.
BMJ 2002;325:1018-1020 ( 2 November ) Clinical review Integrated narrative
and evidence based case report. Case report of paroxysmal atrial
fibrillation and anticoagulation
Reis et al
http://bmj.com/cgi/content/full/325/7371/1018
The authors state "This paper tries to bridge gaps between a patient's and
doctor's narratives and the evidence."
The authors describe how they listened to their patient and helped her to
arrive at a decision not to take warfarin after a cardiologist had
recommended she take it for AF. Reading their report, it seemed to me that
the patient had had a dysfunctional consultation in which she felt that her
feelings and beliefs were ignored. It is fallacious to go from the fact that
there is evidence favouring the use of warfarin in AF to the belief that you
should use it and then to go on to wield this belief as proof that EBP
dictates what patients should do.
--
Kev (Kevork) Hopayian
GP, The Surgery, Main St, Leiston, Suffolk, IP16 4ES, England
Tel +44 (0)1728 830526
Fax +44 (0)1728 832029
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