Unlike jurors, clinicians frequently must make decisions withoutthe luxury of the totality of evidence. When we speak of evidence-basedmedicine, it is important to remember that available data maybe incomplete, outdated, and of questionable relevance to particularpatients, especially those excluded from randomized trials.Nowhere is this more apparent than in the controversies surroundingthe use of drug-eluting stents in patients with coronary disease.
Pivotal trials of drug-eluting stents reported significant reductionsin the rate of repeat revascularization without excess adverseevents in the first year after placement of the stent.1,2 Althoughthese randomized trials were well designed . . . [Full Text of this Article]
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From Harvard Medical School and the Cardiovascular Division, Beth Israel Deaconess Medical Center — both in Boston.
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