JCE誌 (2017; 84)におけるControversy and Debate(April 2017)
●Fava AG. Evidence-based medicine was bound to fail: a report to Alvan Feinstein
●Gordon Gの反論:EBM has not only called out the problems but offered solutions
●Ioannidis JPAのコメント:Hijacked evidence-based medicine: stay the course and throw the pirates overboard
Gordonの反論は、そのまま日本の現状に当てはまる。
診療ガイドライン作成者は、Gordonの主張の意味を理解してほしい。
Individualized care is at the heart of EBM. EBM provides guidance for when to believe subgroup analyses (seldom); when and how one can individualization care through N of 1 RCTs (sometimes); when and how to consider baseline risk in trading off benefits and harms (often); and when and how to consider individual patient values and preferences (always) |