British Columbia Medical Journal
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Home > Re: Circumstantial evidence-based medicine

Issue: BCMJ, vol. 54, No. 7, September 2012, [1] Pages 325-326 Letters
By: Frances Rosenberg, MD, [2]
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I read with interest the article “Prescri­bing second-generation antipsychotic medications: Practice guidelines for general practitioners” [BCMJ 2012;54:75-82 [9]]. As a laboratory phy­­sician, my interest was piqued when I noticed that the recommended laboratory eval­uations included fasting insulin under certain circumstances. 

As it was un­clear to me how this investigation could contribute anything other than cost to the assessment, I decided to investigate the basis for this recommendation. As it was based on the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) guidelines, I review­ed the relevant guideline. 

During the course of this review I learned “if there is good evidence that a specific side effect occurs with SGA treatment, monitoring for the specific side effect may improve health outcomes in the long term.” This is what I (though I am not a lawyer) would consider circumstantial evidence. As a laboratory physician and the chair of the BCALP Tariff Committee, I can assure you that the Medical Services Plan would not consider this an adequate justifica­tion if we were to submit it in support of a new or otherwise modified fee.
—Frances Rosenberg, MD
Victoria

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Source URL:https://bcmj.org/letters/re-circumstantial-evidence-based-medicine

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[1] https://bcmj.org/cover/september-2012 [2] https://bcmj.org/author/frances-rosenberg-md [3] https://bcmj.org/node/4505 [4] https://bcmj.org/print/letters/re-circumstantial-evidence-based-medicine [5] https://bcmj.org/printmail/letters/re-circumstantial-evidence-based-medicine [6] http://www.facebook.com/share.php?u=https://bcmj.org/print/letters/re-circumstantial-evidence-based-medicine [7] https://twitter.com/intent/tweet?text=Re: Circumstantial evidence-based medicine&url=https://bcmj.org/print/letters/re-circumstantial-evidence-based-medicine&via=BCMedicalJrnl&tw_p=tweetbutton [8] https://bcmj.org/javascript%3A%3B [9] https://bcmj.org/content/prescribing-second-generation-antipsychotic-medications-practice-guidelines-general-practit [10] https://bcmj.org/modal_forms/nojs/webform/176 [11] https://bcmj.org/%3Finline%3Dtrue%23citationpop