To the Editor: In response to Leeder and Rychetnik's article,1 evidence-based medicine (EBM) also has significant potential to reduce the quality of patient care, with obvious ethical implications. I refer to two specific issues of concern.
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- 1. Leeder SR, Rychetnik L. Ethics and evidence-based medicine. Med J Aust 2001; 175: 161-164.
- 2. Australian and New Zealand College of Anaesthetists Review E11. Formal project: guidelines for completion of a formal project to be a requirement for the award of the diploma of FANZCA endorsed in Anaesthesia. Melbourne: Australian and New Zealand College of Anaesthetists, 1992.
- 3. Freiman JA, Chalmers TC, Smith H, Kuebler RR. The importance of beta, the type II error, and sample size in the design and interpretation of the randomised controlled trial: survey of two sets of "negative" trials. In: Bailar JC, Mosteller F, editors. Medical uses of statistics. 2nd ed. Boston, Mass: NEJM Books, 1992: 357-373.
- 4. Moher D, Dulberg CS, Wells GA. Statistical power, sample size, and their reporting in randomized controlled trials. JAMA 1994; 272: 122-124.
- 5. Shende D, Bharti N, Kathirvel S, Madan R. Combination of droperidol and ondansetron reduces PONV after paediatric strabismus surgery more than single therapy. Acta Anaesthesiol Scand 2001; 45: 756-760.
- 6. Gore SM, Jones G, Thompson SG. The Lancet's statistical review process: areas for improvement by authors. Lancet 1992; 340: 100-102.
- 7. Kerridge I, Lowe M, Henry D. Ethics and evidence-based medicine. BMJ 1998; 316; 1151-1153.
- 8. Leeder SR, Rychetnik L. Ethics and evidence-based medicine. Med J Aust 2001; 175: 161-164.
- 9. National Health and Medical Research Council. National Statement on Ethical Conduct in Research Involving Humans. Canberra: NHMRC, 1999.
- 10. Casarett D, Karlawish JHT, Sugarman J. Determining when quality improvement initiatives should be considered research. JAMA 2000; 283: 2275-2280.
- 11. Leeder SR, Rychetnik L. Ethics and evidence-based medicine. Med J Aust 2001; 175: 161-164.
- 12. Sackett DL, Rosenberg WM, Gray JA, et al. Evidence-based medicine: what it is and what it isn't. BMJ 1996; 312: 71-72.
- 13. Mathers CD, Vos ET, Stevenson CE, Begg SJ. The Australian burden of disease study: measuring the loss of health from diseases, injuries and risk factors. Med J Aust 2000; 172: 592-596. <eMJA full text>
- 14. NHMRC Strategic and Priority Driven Research Program. Available at: http://www.health.gov.au/nhmrc/research/spdres.htm (accessed September 2001).
- 15. Rogers v Whitaker (1992) 175 CLR 479.
- 16. Leeder SR, Rychetnik L. Ethics and evidence-based medicine. Med J Aust 2001; 175: 161-164.
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None declared.