Standards, guidelines and the practice of medicine
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Experience is fallacious and judgment difficult.
Hippocrates, Aphorisms 1.
The absence of evidence is not the evidence of absence.
G.A.Fitzgerald: “Coxibs and cardiovascular disease” NEJM 2004, 351: 1709.
Lady Thatcher: Guidelines are exactly what they say they are. They are guidelines. They are not the law.
Question: But do they have to be followed?
Lady Thatcher: Of course they have to be followed, but they are not strict law. That is why they are guidelines and not the law, and, of course, they have to be applied according to circumstances…
UK Inquiry into the “Arms to Iraq” affair.
Traditionally, the practice of medicine was based on three pillars, knowledge, experience and, when needed, the opinion of trusted colleagues.
Knowledge was acquired at Medical School and reinforced/updated by reading textbooks and medical literature. Experiencecame with age, was cumulative and could be general or, sometimes, highly specialized. The opinion of colleagues was obtained through...
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