Modern medicine has brought remarkable
advances. The application of scientific rigour to the art of healing has
resulted in a better understanding of diseases, a proliferation of new
treatments and has given hope to many. In large areas of medicine however, the
complexity of the health condition and the heterogeneity of patient
characteristics means that experimental studies such as randomised controlled
trials are too costly and often too difficult to conduct with the necessary
rigor.
Furthermore, the proliferation of new studies
means that it is impossible for a practitioner to keep abreast of the latest developments
in all but the very narrowest of fields. Even evidence based medicine
approaches such as the development of systematic review methodology can only
partially address this problem because of the volume and complexity of studies. The net result is that much medical practice
still relies on gut feeling and all of the associated biases.