In their article “Evidence-Based Medicine: 5 Steps to Navigate Uncertainty”, R Martin-Masot et al.1 outline the key steps for a structured and practical approach in our search of scientific evidence to support clinical decision-making.
Indeed, this is a useful and necessary article, as it provides important clues to ensure that we search for evidence effectively.
It is essential to identify and formulate clinical questions correctly. This first step is crucial. We also consider the second step, concerning the screening of available information, important and instructive, ensuring that sources are scientifically rigorous and appropriate for our needs.
The point with which we may differ from the authors or perhaps have a suggestion concerns the third step: choosing to appraise rather than believe. When it comes to this step, the authors suggest that it is the readers of a scientific article that need to appraise whether the evidence provided is valid (scientific rigor), that need to choose whether we are satisfied with taking what we read at face value. In other words, it falls upon the consumer of the scientific literature to determine whether the evidence read is valid (whether the study is methodologically sound) or not, taking for granted that the reader has specific training on the critical appraisal of scientific literature.
They use as an example an article published in 2003 on the diagnostic accuracy of the Helicobacter pylori stool antigen test, an enzyme immunoassay technique. In this article, despite its having been published, the method used as reference was not valid, as the actual gold standard would be the gastric tissue biopsy and examination.
In our opinion, it is the responsibility of the publishers of scientific evidence and their editorial teams to determine whether an article is methodologically valid and meets the criteria for publication.2–4
From our perspective as consumers of scientific literature, this would guarantee that published articles have already been critically appraised and that their contents will help us increase our scientific knowledge and make the best possible decisions for our patients.
We, in any case, express our sincere appreciation for the contributions of this article.
