Uncontrolled data

Empirical, uncontrolled and non-systematically collected data form the basis of much of dermatology practice. This situation is justified by its advocates by two erroneous assumptions. The first is that it is acceptable to use such data because better evidence is not available - an assumption that is often not true. There is a surprisingly large body of high-quality evidence that is useful for the care of patients with skin disease. The second erroneous assumption is that the majority of dermatologists already base their practice on the best evidence that is already available. The base of knowledge for the practice of medicine is expanding exponentially. It is estimated that to keep up with the best evidence available, a general physician would have to examine 19 articles a day, 365 days a year.2 Therefore, keeping up to date by reading the primary literature is now an impossible task for most practising physicians.20 The burden for dermatologists is no less daunting.5 The trick is to know how to find information efficiently, appraise it critically and use it well. Knowing the best sources and methods to search the literature allows a dermatologist to find the most current and most useful information in the most efficient manner, when it is needed. The techniques and skills needed to find, critically appraise and use the best evidence available for the care of individual patients have been developed over two centuries. These techniques and skills are currently best known as EBM.10

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