Re: ob profession (was postpartum intercourse)

From: Robert J Woolley (wooll005@gold.tc.umn.edu)
Mon Jun 30 10:52:23 1997


On Mon, 30 Jun 1997, Robert J. Woolley wrote:

>
> BTW, you misrepresent me: I do not require RCTs for every conclusion I draw or
> every clinical judgment I make. They simply do not exist for many, many
> questions. However, you are arguing for ignoring a conclusion agreed on by
> several RCTs, and I have not heard you justify that position yet. Please

Let me try to state this a little more clearly.

I am arguing that we should always use the best evidence available. When the evidence is very good, such as several well-done RCTs all coming to the same conclusion, the evidence is such that it will difficult to practice contrary to it. However, often the evidence is second-rate, with flaws and biases, and it then becomes easier to make a case for exceptions, or even a general rule of practice that is out of line with the findings. But in general, I argue for accepting better quality evidence over lower quality evidence. Your position, though I suspect you will want to deny it, is arguing for lower quality evidnece (personal anecdotal experience) over higher quality evidence (several RCTs), and it is that which I challenge.





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