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I am an Emergency Medicine (EM) physician. Our motto is “Don’t just stand there! Do something! I like adrenaline (or epinephrine for us Americans), difficult decision, loud environments, procedures and definitive answers. Evidenced Based Medicine (EBM) and literature reviews fall into none of these categories… We expect to read a study and get an answer but that is just not a reality. Studies (even on the same topic) are done differently, ask different questions, are done in different settings, on different patients and therefore come up with different answers. I’ve heard these stated different ways, from “I hate journal club”, to “The answer to all EBM is: It depends”, to my favorite (from Mark Crislip, he runs a great podcast by the way) who applies the second law of thermodynamics to the literature: “For every study there is an equal and opposite study”. Therefore, really the answer to all EBM questions is that there are a lot of ways to do things that don’t change the outcome (Not quite T-shirt worthy, I know). But this is EXACTLY why we should know how to read the literature! So we can know which things we do that won’t influence change (Just stand there) and which things we do that will influence change (Do Something!) …Oh look, I guess EM IS like EBM (just add the B).

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The information contained herein is for practicing clinicians and not meant for medical advice. Guidelines, Algorithms, Decision tools, and reviews are NEVER substitution for clinical judgement.

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