Dear all,
I was reminded of this by the posting on the EB-Oncology conference -- and
I know nothing about that particular meeting so please don't take this as
directed towards it.
My hospital recently consulted me about the advisability of sending one
member of each Obstetrics group to a nearby day-long conference entitled
"Evidence-Based Obstetrics" sponsored by a nearby medical center which
does a large volume of CME. I looked at the program and the topics
looked like ones that would lend themselves well to EBM-type discussions.
The actual content turned out to be very disappointing, and probably did
significant HARM in terms of promoting EBM approaches among our OB's, one
of whom told me once that "EBM cannot be done in OB because the only
outcomes are a dead baby or a dead mother". Essentially, most
presentations were the same old "review of the literature" by an expert
repackaged as "EBM". I think the word "meta-analysis" was mentioned
once. Likelihood ratio was mentioned once in the context of promoting a
new test, though nobody explained what a LR is. There was a brief
introduction on the definition of EBM by a perinatologist who clearly had
limited familiarity with EBM and focused on its limitations. The most
appropriate and stimulating discussion (I thought) was by a general
surgeon talking about the quantitative risks and benefits of treating
gallbladder disease in pregnancy. I rolled my eyes to the point of
vertigo at the number of times the speakers said, "Well, the
evidence says do this, but in reality I do that". Anything even
approaching the concept of NNT, or the Cochrane Database -- forget
it!
I'm concerned about the proliferation of "EB-CME" courses, and how we
"local experts" can help our colleagues pick out the ones that are truly
based upon principles of EBM/EBHC, versus those that throw the phrase
into the title in order to market the program. Should we
internationally trademark the phrase and accredit CME courses that wish to
promote themselves as evidence-based? (Only 95% joking on that one).
I'd be curious to hear others' experiences. I feel that I got a bit
burned on this one, and I'm certainly going to be extremely careful in
the future in endorsing anything as evidence-based until I know the
details. Sorry for the long venting message!
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