Evidence-Based Medicine

As someone who has been out of residency just over a year, I find that I completely agree with Dr. Susan Padrino’s comments on evidence-based medicine in the August 16 issue. While cookbook medicine removes the human factor from much of the equation, I think in the big picture the advantages to patient care are greater than the disadvantages (and someday the human factor may be understood well enough to factor it into the cookbook).

Aside from writing to thank Dr. Padrino for the article, I wanted to vent some of my own frustration with our developing database of evidence. I know many others are concerned with corporate bias in our practice patterns, but I wanted to point out one more observation from this issue of Psychiatric News.

Dr. Padrino’s column is on page 13. The large ad on page 11 is for escitalopram (Lexapro). On page 17 is an “article” on escitalopram but without any reference to a peer-reviewed study. Some psychiatrists may even mistake reading that article as “evidence-based medicine” when they choose to prescribe escitalopram. Personally, I know next to nothing about escitalopram (yet), so maybe it is the greatest thing since sliced bread. I’ll wait for some peer-reviewed publications.

Editor’s note: Dr. Malis makes an excellent point about waiting to reach a judgment on the usefulness of research findings for clinical decisions until more information appears in a peer-reviewed journal. As a newspaper, an important part of Psychiatric News’s mission is to inform readers about medical and scientific developments that could have an impact on diagnosis and treatment. This enables readers to remain up to date on trends in research and clinical practice and to seek out more information on topics of particular interest to them, including information that can help them reach sound clinical decisions.