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November 3, 1993

Users' Guides to the Medical Literature

Author Affiliations

From the Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Dr Guyatt), and Institute for Health Policy Studies, University of California, San Francisco (Dr Rennie). Dr Guyatt is a Career Scientist of the Ontario Ministry of Health. Dr Rennie is Deputy Editor (West), JAMA.

JAMA. 1993;270(17):2096-2097. doi:10.1001/jama.1993.03510170086037

Medical practice is constantly changing. The rate of change is accelerating, and physicians can be forgiven if they often find it dizzying. How can physicians learn about new information and innovations, and decide how (if at all) they should modify their practice?

Possible sources include summaries from the medical literature (review articles, practice guidelines, consensus statements, editorials, and summary articles in "throwaway" journals); consultation with colleagues who have special expertise; lectures; seminars; advertisements in medical journals; conversations with representatives from pharmaceutical companies; and original articles in journals and journal supplements. Each of these sources of information might be valuable, though each is subject to its own particular biases.1,2 Problems arise when, as is often the case, these sources of information provide different suggestions about patient care.

See also p 2093.

Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information

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