This is the authors' abstract. We don't add key points for this paper.
Summary points: Even "evidence based" clinicians uphold the importance of clinical expertise and judgment. Clinical method is an interpretive act which draws on narrative skills to integrate the overlapping stories told by patients, clinicians, and test results. The art of selecting the most appropriate medical maxim for a particular clinical decision is acquired largely through the accumulation of "case expertise" (the stories or "illness scripts" of patients and clinical anecdotes).The dissonance we experience when trying to apply research findings to the clinical encounter often occurs when we abandon the narrative interpretive paradigm and try to get by on "evidence" alone.
Answers are grounded in this paper and cite their sources.
No takes yet. Share an insight, caveat, or question.
Trisha Greenhalgh (1999) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: