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Beware pitfalls of evidence-based care

In the current climate of evidence-based practice we should not forget the pitfalls. In many treatments – HRT being one – the benefits to the patient are immediate and obvious. But the risks are not.

Risk assessment is based on the results of large statistically validated studies that will accurately predict the risk in a population but not in an individual. If, for example, a risk is defined as one in 1,000 then it follows that one person will have all of it and 999 none of it. 

One is reminded of the advice from a statistician to someone concerned about the risks of being blown up in an aircraft.

He advised that since the risks of a bomb being on a aircraft were small but calculable, but the risks of two bombs being on the same aircraft were incalculably small, then the individual could protect himself by always carrying a bomb himself whenever he flew in an aeroplane. Nuff said?

Dr Michael Blackmore

Independent GP



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