Evidence-based medicine has little measurable impact on choice of treatment and doctors "continue to believe what they are doing is right, even in the face of evidence to the contrary," according to Dr Darren McGuire and colleagues (Duke Clinical Research Institute, US) presenting on March 13 at the annual scientific meeting of the American College of Cardiology.
They found that there had been no increase in the use of coronary bypass surgery for diabetic patients five years after the publication of a "milestone" trial that showed that patients with diabetes fare best after bypass surgery instead of angioplasty. When asked the reason by the researchers, cardiologists and surgeons said that, while they agreed that the trial results could apply to their patients, it did not yet affect their personal treatment choices. "For evidence-based medicine to work, you have to know about the data, believe it and, most importantly, practise it," say the authors.