Applying research evidence to individual patients

Clinical review p 1660 At the heart of clinical medicine is an unresolved conflict—between the essentially case based nature of clinical practice and the mainly population based nature of the research evidence. While clinicians are exhorted to use up to date research evidence to give patients the best possible care, actually doing so in individual patients is difficult. The reasons are well known.1 The research literature is poorly organised,2 largely of poor quality and irrelevant to clinical practice,3 often conflicting, and often not there at all.4 The most valid and, at first sight, relevant information may be based on highly selected groups of patients bearing little resemblance to the patient in front of you. And statistical probabilities may mean little to you or your …