When clinical practice guidelines meet the black box.

摘要

Promoting evidence-based medicine by encouraging adherence to evidence-based guidelines can substantially improve clinical care. The data inputs for these guidelines typically include clinical trials, observational studies, and expert opinion; another option, mathematical modeling, is generally not part of the mix. Many physicians distrust decision-analytic models because they are essentially intricate "black boxes" whose assumptions and mechanics often seem inaccessible. But such analyses can improve our understanding of treatment strategies and provide an important perspective well worth examining.