Evidence under judgment: can we oversee our own decision making?

摘要

IN DEFINING EVIDENCE-based medicine, Sackett and colleagues stated that practicing it "means integrating individual clinical expertise with the best available external clinical evidence from systematic research." Fifteen years later, the regulatory pendulum has swung far toward the preference for the latter and away from the former. Most recently, the proposal by the White House to immunize physicians who follow evidence-based practice guidelines from malpractice suits signals a tacit encouragement to continue in the same direction, further limiting individual clinical judgment.