One criticism that has been leveled at evidence-based medicine is that it can be applied well to populations of patients but may fail when it encounters the vagaries and variations of individual patients.1 In her fine commentary, Schattner2 addresses this criticism with her argument that the MEDLINE search can become, in essence, a powerful diagnostic maneuver for individual patients with complex, puzzling problems. In 3 of the 5 cases Schattner2 presents (fever of unknown origin due to aortic dissection; cytomegalovirus colitis complicating ulcerative colitis; and Sjögren syndrome with neutropenia and positive rheumatoid factor), the patient workups were either at a standstill or headed in wrong and potentially harmful directions until a literature search was performed.
Packer CD. The MEDLINE Search as a Diagnostic Maneuver. Arch Intern Med. 2005;165(6):703-704. doi:10.1001/archinte.165.6.703-b