Expert opinion

Expert opinion can be valuable, particularly for rare conditions in which the expert has the most experience or when other forms of evidence are not available. However, several studies have demonstrated that expert opinion often lags significantly behind conclusive evidence.14 Experts suffer from relying on bench research, pathophysiology, and treatments based on logical deduction from pathophysiology, and from the same pitfalls noted for relying on personal experience.18

Textbooks can be valuable, particularly for rare conditions and for conditions for which the evidence does not change rapidly over time. However, textbooks have several well-documented shortcomings. They tend to reflect the biases and shortcomings of the experts who write them. By virtue of how they are written, produced and distributed, most are about 2 years out of date at the time of publication. Also, most textbook chapters are narrative reviews that do not consider the quality of the evidence reported.14,1819

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