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April 14, 2004

Evidence-Based Medicine on Trial

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(14):1696-1698. doi:10.1001/jama.291.14.1696-d

To the Editor: In his A Piece of My Mind article, Dr Merenstein1 described his lawsuit in which a jury returned a verdict against the teaching of evidence-based medicine (EBM). Written as a fugue, each iteration became more dissonant and disturbing than the one before.

How now do I counsel and advise my patients? What words do I place in the record to document "informed consent?" How and what do I teach my residents? What is the role of EBM? Wherein is the value of meta-analyses? Should the American Academy of Family Physicians and others revise their guidelines? Primary care—that is, good primary care—the primary care that takes the time to actually talk to patients and elicit their values, is already an endangered species. How has this happened and who will protect us?

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