This is an issue which I have been struggling with as well,
but probably from a somewhat different perspective. Andy Oxman published
several years ago paper showing that "experts with high experience in a
subject are less able to produce objective review of scientific evidence
than non-experts trained in critical appraisal of evidence" (Oxman, A. D. &
Guyatt, G. H. (1993) The science of reviewing research. Ann NY Acad Sci,
703, 123-31.). This is very "hot" issue for guidelines developers, and deals
with the key dilemma of inherent value of axiomatic postulates of
well-design clinical studies (such as RCT) vs. content-specific expertise,
which many physician believe should be of the most importance. Note that
this relates to the question of interpretion of evidence, and not to giving
specific recommendations to individuals (such as our patients, etc).
it would be very interesting to hear other members' opinion
on this important topic
many regards
bd
Benjamin Djulbegovic, MD
Associate Professor of Medicine
H. Lee Moffitt Cancer Center & Research Institute
at the University of South Florida
Division of Blood and Bone Marrow Transplant
12902 Magnolia Drive
Tampa, FL 33612
Editor: Evidence-based Oncology
e-mail:[log in to unmask]
http://www.hsc.usf.edu/~bdjulbeg/
phone:(813)979-7202
fax:(813)979-3071
> -----Original Message-----
> From: Jonathan BRASSEY [SMTP:[log in to unmask]]
> Sent: Thursday, November 04, 1999 9:17 AM
> To: [log in to unmask]
> Subject: Question answering
>
> I have recently had a series of conversations regarding clinical
> question answering with some health 'officials' here in Wales. They
> are of the opinion that only health professionals can answer their
> own clinical questions (irrespective of time pressures, searching
> skills etc.) as only they know of the context etc. They believe that
> third parties are incapable of answering other people questions.
>
> This to me seems a ridiculous position as I regularly answer
> questions on behalf of GPs - and they always seem happy with the
> answers I give. However, I am struggling to put together a counter-
> argument, any ideas of how I should structure such a response?
>
> My ideas to date hinge around 'Sackett's' structured question
> which should allow anyone (with searching and critical appraisal
> skills) to answer the question.
>
> Any thoughts (even if you think I'm wrong) would be welcomed.
>
> Many thanks
>
> Jon
>
>
> Jon Brassey
> Assistant Director
> CeReS
> Tel: 02920 746604
> www.ceres.uwcm.ac.uk
> Primary Care Wales
> Telephone: 01222 746604
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