Many physicians take great pride in the practice of evidence-based medicine. Modern medical education emphasizes the value of the randomized, controlled trial, and we learn early on not to rely on anecdotal evidence. But the application of such superior evidence, however admirable the ambition, can be constrained by trials' strict inclusion and exclusion criteria — or the complete absence of a relevant trial. For those of us practicing pediatric medicine, this reality is all too familiar. In such situations, we are used to relying on evidence at Levels III through V — expert opinion — or resorting to anecdotal evidence. . . .
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
This article (10.1056/NEJMp1108726) was published on November 2, 2011, at NEJM.org.
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