SHARON E. STRAUS, M.D.
University of Calgary
Calgary, Alberta
PAUL GLASZIOU, PH.D.
University of Oxford
Oxford, U.K.
I appreciate Dr. Healy's astute comments about EBM. As advances are made in today's medicine, particularly geriatrics, I believe it is best to have the diagnosis of the attending physician first and foremost in the consideration of treatment. EBM may be a point of reference, yet it is no substitute for the first-hand deductions of the attending physician for resultant successful outcomes.
AUSTIN R. CURRY
Executive Director
Elder Care Advocacy of Florida
Tampa
To me, the original push toward EBM was to delineate guidelines as to when science was clear about there being scientific proof of treatment effectiveness and when it was not clear. But EBM was never meant to discard treatments as ineffective if they didn't meet strict criteria. Lots of treatments in the medical world are difficult to prove scientifically. In reality, the areas where EBM is clear are few. Clinicians in the field, however, see insurance companies repeatedly using those standards to deny access to reasonable treatments. EBM was not meant to deny those treatments but rather to raise a level of awareness as to which medical practices have clear evidence and which don't yet have clear evidence.
RICHARD RUFFING, M.D.
Gaffney, S.C.
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