Problems in the Handling of Clinical and Research Evidence by Medical Practitioners

• There are important problems in the accuracy with which we collect, interpret, communicate, and apply clinical and relevant research evidence in the care of our patients. Many of these problems can be avoided or ameliorated by applying some specific measurement principles and information tools. The collection of clinical evidence can be improved by adhering to strategies that reduce observer error. The interpretation of clinical and paraclinical information can be improved by harnessing the predictive value of this information to estimates of the diagnosis, prognosis, and therapeutic responsiveness of patients. Communication can be improved by replacing the ambiguous argot of clinical equivocation with a more precise terminology. The detection of both valid and useful new knowledge can be facilitated by applying some straightforward guidelines to the rapid critical appraisal of the medical literature. Finally, we can look to advances in information technology to help us become more consistent in providing the best possible care for our patients.

(Arch Intern Med 1983;143:1971-1975)