EBM can obscure realities
I appreciate Current Psychiatry’s practical approach, but psychiatry’s tidal wave of evidence-based medicine (EBM) guidelines can obscure obvious realities, in turn serving to dumb us down. The article “Clozapine for schizophrenia: Life-threatening or life-saving treatment?” (Current Psychiatry, December 2009) is an example of how so-called “objective” statistics hide fuzzy assumptions. The idea that those rare outpatients with support systems and egos consistently functional enough to adhere to lab testing and who accept their illness are representative of all schizophrenia patients is a whopper of an assumption. The author needs to consider the more mundane possibility that patient selection and not the drug itself may make the difference.
I feel that articles on “CBM” for common sense-based medicine or “WBM” for wisdom-based medicine would provide our profession with a fresh breath and a dose of reality. The drum-beat of the EBM march is promoted as a substitute for thinking, which it isn’t. It is just a tool.
Peggy Finston, MD