Sunday, October 07, 2007

some studies have shown that other studies have shown that some studies are useless

the deal with evidence-based medicine, which is the new mantra in clinical education, is that a lot of it is so specific and so precise that is stops being adaptible. as an intern i go to a textbook or an article to glean general priniciples which i can then derive and customize to the needs of my patient. but to sit at two am on the ward in front of a computer screen trying to figure out the pliability of a study done in papua new guinea on a cohort of schoolchildren from 6 to 6.24 years with a mean height of 45.8 and a shoe size of 5 (plus or minus two standard deviations) is absurd. i refuse to buy into that kind of research, which, while ostensibly contributing to a notion of progress, actually just ends up choking the reader in a confusing miasma of statistics and inferential bias. for a scientist it may carry weight, helping to float the ethos of scientific purpose, but for a physician it's just so much jargon. and patients deserve better. i deserve better. as an intern, my ability to retain knowledge is suboptimal at best and, in the frenzy of work pressures, i need information that is quick and comprehensive and that will empower me to practice safe and efficient medicine. a lot of the research i go through right now just doesn't cut it and i'm beginning to wonder whether the emphasis on EBM isn't misplaced. maybe i should just dispense with the idea of avante-garde scholarship and read the textbooks instead. bulky as they are, textbooks frame general principles exceedingly well and have the added benefit of authority. they also make good paperweights for all the photocopies scattered around my room, all those slick journal articles that are so new and never read.

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