Clinicians vs Researchers: Who Should You Believe?

There seems to always be some level of a cultural clash between general practitioners who are working “in the trenches” and the academicians living “in their ivory towers”.

For practitioners, the ideal situation, of course, is to take a balanced approach that incorporates the latest research into your clinical practice so that you can continually grow and improve your patient care.

In this blog post, we will first distinguish between two types of information and then talk about the different levels of evidence-based medicine.

Two types of information

When seeking reliable information for clinical decision making, it is essential to differentiate between two distinct types of information – knowledgeable sources and opinion-based information – and to understand those differences in order to properly evaluate the information’s credibility and reliability.

Knowledgeable sources:

  • A knowledgeable source is typically an expert or authority in a particular field or subject matter.
  • Knowledgeable sources have a deep understanding of the topic, often based on extensive education, research, or practical experience.
  • They provide information that is supported by evidence, facts, and data.
  • They often publish their findings in reputable peer-reviewed journals, books, or other scholarly publications.
  • Information from knowledgeable sources is generally considered reliable and credible.

Opinion-based information:

  • Opinion-based information is subjective and reflects the personal beliefs, views, or preferences of the individual expressing it.
  • It may lack concrete evidence or objective facts to support the claims being made.
  • Opinion-based information can be biased, as it often represents the perspective or agenda of the person sharing the opinion.
  • This type of information can be found in various forms, including editorials, blog posts, social media comments, and personal conversations.
  • It is not necessarily based on expertise or comprehensive research and should be evaluated critically.

Typically, knowledgeable sources provide information grounded in expertise and scientific evidence, while opinion-based information reflects personal viewpoints and may lack objectivity. Both types of information have their place, but it’s crucial to distinguish between them and to use them appropriately depending on your informational needs.

When evaluating information, remember to:

  • Check the source – Determine whether the source is an expert in the field and has a track record of providing accurate information.
  • Look for evidence – Seek information that is backed by data, research, or verifiable facts.
  • Consider multiple perspectives – Avoid relying solely on a single person with opinion-based information and seek a variety of sources to get a well-rounded view of a topic.
  • Be critical –Assess the credibility of the information and its potential bias, especially when it comes to opinion-based content.

Evidence-based medicine

Evidence-based medicine aims to improve the quality of healthcare by ensuring that clinical decisions are based on the best available evidence. It integrates clinical expertise, patient values and preferences, and the most up-to-date research evidence to guide medical diagnosis, treatment, and patient care. It is an iterative process that continually grows and evolves as new evidence emerges. What was considered the best form of diagnosis or treatment 10 years ago may not have the highest level of evidence or support today.

Scientific evidence is typically categorized into different levels of quality and reliability based on the rigor of the research methods used and the strength of the findings. These levels are often organized into a hierarchy and categorized as having low, medium, or high levels of evidence.

Here is a typical hierarchy, from low to high levels of evidence:

  • Anecdotal evidence: This is the lowest level but provides the largest amount of evidence. Anecdotal evidence is often unreliable because it is based on personal experiences and may not be representative of the broader population.
  • Expert opinion: Expert opinions are based on the knowledge and experience of individuals who are considered authorities in a particular field. While expert opinions can be valuable, they are still considered relatively weak evidence because they are subjective and not based on empirical research.
  • Case reports: These are observational studies that describe the experiences of a small number of individuals or cases. While they can provide valuable insights and generate hypotheses, they are limited by their small sample sizes and lack of control groups.
  • Case-control studies: Case-control studies compare individuals with a specific condition (disease) to those without (controls) and look back in time (are retrospective in nature) to identify potential risk factors. They are valuable for investigating associations but may still be subject to biases.
  • Randomized controlled trials: These studies are considered the gold standard for research. They involve randomly assigning patients to different groups (treatment and control) and then measuring the effect of an intervention prospectively. Randomized controlled trials are preferred because they minimize biases and can be helpful to establish cause-and-effect relationships.

In conclusion, to provide the most comprehensive understanding of a particular topic, multiple types of scientific evidence are often needed and considered together.

It is essential that practitioners pursue ongoing education and professional development to stay up to date on the latest clinical insights and research discoveries. What is your personal continuing education status?

This is the last of four blog posts in our scientific accuracy series. Consult the first three posts at vetspine.org/blog 

Then join us on October 26, 2023, on a free zoom, to share your views about this important topic. Register at vetspine.org/webinars/   

In the meantime, participate in the thoughtful conversation taking place on the Veterinary Compendium Facebook page.

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Resources

Want to learn more?

Browse our RACE-approved catalog of online learning modules.