THE TERM evidence-based medicine refers to an approach to problem solving and continual professional learning that requires the use of the current best evidence in making medical decisions about individual patients. Generally, evidence-based medicine encourages the use of treatment procedures that have been empirically validated and published in peer-reviewed journals.
The area of toilet training and toilet-training problems is a fascinating one. All children eventually are toilet trained, and virtually every parent and many day-care workers have to do it. Yet, at present, there is very little in the way of empirical data to guide the primary care physician in making recommendations to parents about toilet training or the problems that come when toilet training is unsuccessful. In a review of the literature on treating problems related to toilet training, such as encopresis, functional constipation, and stool toileting refusal, Brooks et al1 concluded that "no randomized, controlled treatment studies involving preschool-age children have been published."1(p260)