Are neurologists really data driven in selecting epilepsy treatment?

Abstract

Neurology is considered a cognitive field, with thoughtful practitioners who are driven by empiric data. With the development of guidelines, practice parameters, and now a review of how physicians practice, this notion could be called into question. There is no doubt that evidence-based medicine (EBM) should be and is the basis for the practice of modern medicine. Medical school curricula worldwide have recognized the importance of EBM, incorporating it into standard medical student education. The American Academy of Neurology (AAN), recognizing the need to supplement this type of thinking, developed a resident education program covering the basics of EBM.1 So how do we as neurologists fare in the practice of EBM? Our track record is mixed. We hear our colleagues utter, “there is no evidence to support that.” That statement is more an editorial comment than a valid conclusion. EBM is built on the principle that there exists a hierarchy of evidence, some of which is strong and other weak, with the rest falling somewhere in between. Data, properly collected, should not be considered valid or invalid, but rather strong or weak. Similarly, an individual's opinion should not be thought of as valid …