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Changes in Practice Bring Cardiologists Conflicts

Donald F. Phillips
JAMA. 1996;275(17):1300-1301. doi:10.1001/jama.1996.03530410012005.
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THE EXPONENTIAL growth of medical information, coupled with efforts to establish a system of evidence-based medicine, will create inevitable conflicts as cardiologists adapt to new demands under health care system reform, predicted Thomas Killip, MD, chief of cardiology at Beth Israel Medical Center, New York, NY, at the opening plenary session of the American College of Cardiology meeting. His presentation, "Evidence-Based Practice and Health Care Reform," was this year's Simon Dick Lecture.

"Evidence-based medicine" is defined as the use of scientific data to confirm that proposed diagnostic or treatment procedures are appropriate in light of their high probability of producing the best and most favorable outcome. As a recent article in Science (1996;272:22-24) put it, "all too often physicians rely on custom, hearsay, and dogma in choosing treatments." A new British journal, Evidence Based Medicine, the American College of Physicians' Journal Club, and other programs, said the article, "aim to


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