Evidence based medicine.

Graham Easton discusses whether medical care should be based on evidence. How do you get the 'right' evidence? It has become increasingly possible with computers and the internet to access the latest research data, though it takes time, skill and judgement to do so. A doctor who finds microscopic traces of blood in urine may wish to do more tests, but the evidence from a large Californian study is that the outcome would not be improved. Likewise, it is easier to give an antibiotic for earache than to persuade a parent that the lastest evidence is that in 19/20 cases it will not improve the earache and may have a side-effect. In each case the doctor has to resist his intuitive response, and the request of patients. Dr Cates suggests that a doctor may write a prescription and tell the patient not to use it if possible - give the patient the choice. Evidence may undermine what doctors have done for years.