Once upon a time, physicians used clinical judgement and prescribed, and professional medical societies gave conditional recommendations for, interventions based on low or sometimes very low certainty data. No one called them miracles or referred to them by their veterinary use.
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I have strong feelings about this from my clinical background. There's a default to "no evidence" I don't think is legitimate. The best evidence we have is the best evidence we have, regardless of what we wish. 1/2
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The decision whether it's worth integrating something based on low quality evidence is an assessment of the harms of doing vs harms of not doing, combined with relative chance. But what we can't do is opt out of making treatment decisions until better evidence comes along. 2/2
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The best evidence available should guide practice.
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I agree.
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