Evidence-based medicine is a process. First, investigators test therapies against each other, against nothing, try different tests, frenzy themselves with recruiting patients for one study after another. Others follow after patients, trying to figure out if this sized liver is normal or if it goes bad in ten years. The various studies and types of studies pile up. Then, a clinician, with a patient, tries to read through it all and make the best decision for the individual patient. To do that she needs to be critical of the studies from conception to completion.
In residency, we try to be nice to each other. Life is tough; we try not to make it worse. We support growth and change and sometimes simple survival through the worst of the season. Today, though, I learned that when it comes to studies, I need to be mean.