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Related Experiment Videos

Randomized controlled trials and consensus as a basis for interventions in internal medicine.

A Nordin-Johansson1, K Asplund

  • 1Department of Medicine, University Hospital, Umeâ, Sweden.

Journal of Internal Medicine
|February 15, 2000
PubMed
Summary

Half of internal medicine interventions are supported by randomized controlled trial evidence or expert consensus. This study challenges claims of limited scientific backing for routine clinical practice.

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Area of Science:

  • Clinical Medicine
  • Evidence-Based Practice
  • Internal Medicine Research

Background:

  • Routine clinical interventions in internal medicine often lack clear evidence.
  • Assessing the scientific basis of medical practice is crucial for quality improvement.

Purpose of the Study:

  • To determine the proportion of internal medicine interventions supported by randomized controlled trials (RCTs) or expert consensus.
  • To evaluate the evidence base for common medical treatments.

Main Methods:

  • Retrospective review of 197 medical inpatients' case records.
  • Literature search for RCTs and meta-analyses supporting interventions.
  • Consultation with national expert panels for consensus-based evidence.

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Main Results:

  • 50% of diagnosis-intervention combinations were supported by RCT evidence.
  • 34% were supported by clinician consensus.
  • Evidence from RCTs was highest for cardiac (64%) and circulatory (73%) diagnoses.

Conclusions:

  • Approximately half of internal medicine interventions are supported by RCTs.
  • The findings contradict claims of minimal scientific evidence for medical practice.
  • Evidence base for internal medicine interventions is substantial, particularly in cardiology.