Information and EBM in Nephrology. Epistemology and Bioethics

Abstract

Medical knowledge is fluid and rapidly changing. The clinicians were under increasing pressure to keep up-to-date and to base their practice more firmly on evidence, but few had the time necessary to do this. Then the problem of information is growing up more and more and recommendations are not appropriate in every situation. Differences in the clinical basis of individual patients and in local availability of intervention will always mean that the recommendation must be individually interpreted rather than applied systematically. However, the desire to be completely up-to-date needs to be balanced with the concern that a too rapid integration of the current studies may introduce bias, because studies with positive results are more likely to be published quickly. The philosophy of EBM system is based just on the scientific studies gathered in groups of clinical evidence to be applied to clinical practice. Evidence in nephrology is reported to be related to acute renal failure. Warnings are suggested to avoid to interpret EBM not as a medical gospel of XXI century, but only as a scientific up-to-date aid for clinical practice. (Bioethics)