The Ten Commandments of Evidence Based Medicine

  1. Thou shalt endeavour to provide patient care based on the BEST evidence. (BEEM)
  2. Thou shalt consider benefits of drugs as proven only by hard endpoint studies and not bow down to drug reps literature.
  3. Thou shalt not worship Guidelines, for these are but the creations of Committees which even their own members do not strongly believe in the recommendations.
  4. Thou shalt apply a pinch of salt to Relative Risk Reductions, regardless of P values, for the population of their provenance may bear little relationship to thy daily clientele.
  5. Thou shalt honour the Numbers Needed to Treat (NNT), for therein rest the clues to patient-relevant information and to treatment costs.
  6. Thou shalt also honour the Number Needed to Harm (NNH) such that primum non nocere (first do no harm).
  7. Honour the elderly patient, for although this is where the greatest level of risk reside, so do the greatest hazards to many treatments.
  8. Thou shalt not see drug reps, nor covet an Educational Symposium in a luxury setting like Hawaii.
  9. Thou shalt share decisions on treatment options with the patient in the light of estimates of the individual’s likely risks and benefits.
  10. Thou shalt be skeptical/critical of all that you are taught, even if taught by (insert medschool professor name here)

Emergency Medicine Kenya Foundation