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Special Article
October 18, 2010

Evidence-Based Medicine, the Research-Practice Gap, and Biases in Medical and Surgical Decision Making in Dermatology

Author Affiliations

Author Affiliations: New Product Assessment and External Research, Stiefel, a GSK company, Palo Alto, California; and Department of Dermatology, Miller School of Dermatology, University of Miami, Miami, Florida.

Arch Dermatol. 2010;146(10):1161-1164. doi:10.1001/archdermatol.2010.266

The objectives of this article are to promote a better understanding of a group of biases that influence therapeutic decision making by physicians/dermatologists and to raise the awareness that these biases contribute to a research-practice gap that has an impact on physicians and treatment solutions. The literature included a wide range of peer-reviewed articles dealing with biases in decision making, evidence-based medicine, randomized controlled clinical trials, and the research-practice gap. Bias against new therapies, bias in favor of indirect harm or omission, and bias against change when multiple new choices are offered may unconsciously affect therapeutic decision making. Although there is no comprehensive understanding or theory as to how choices are made by physicians, recognition of certain cognition patterns and their associated biases will help narrow the research-practice gap and optimize decision making regarding therapeutic choices.

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