The liberal use of “no evidence to support” has conditioned us to distrust anything not supported by trial. I’ve taught my students and residents to do better, replacing the sloppy phrase “There is no evidence” with either “It is unknown because it has not been adequately studied” or “It has been studied adequately and has not been shown to be effective.” The concept behind Improving Wisely is to apply the wisdom of expert doctors to identify practice patterns that appear inappropriate. When I show the practice pattern data to doctors and they see outliers, they say “I get it.” No trial
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