• evidence based medicine
• clinical practice

Using the best available evidence is expected of us in clinical practice. How should clinicians get such evidence? Should we all be formulating questions, searching for the evidence and then appraising it? Or as busy clinicians are we forced to rely on the evidence provided for us in published systematic reviews. Rudolf’s recent paper puts one side of the argument.¹ Nine doctors attending at MmedSc Course each spent an average of five hours analysing a clinical problem “in accordance with the principles of evidence based practice”. As a result of this work they judged themselves to have improved in structuring clinical questions, searching electronic databases, and in critical appraisal. In addition they succeeded in highlighting the poor evidence upon which we base much of our practice. I have no doubt that their efforts had an educational value, but would they be right to base their clinical practice on the conclusions of five hours work?

In November 2001, as part of the Archimedes series, two middle grade paediatricians attempted to answer the …