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Clinical decisions should, as far as possible, be evidence based. So runs the current clinical dogma. 1 2 We are urged to lump all the relevant randomised controlled trials into one giant meta-analysis and come out with a combined odds ratio for all decisions. Physicians, surgeons, nurses are doing it 3-5 ; soon even the lawyers will be using evidence based practice. 6 But what if there is no evidence on which to base a clinical decision?
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Isaacs et al. (1999) studied this question.
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