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The following is an extract from Chapter 5 of the book Smart Health Choices aimed at helping consumers take an evidence-based approach to decisions. But we think the 5 questions outlined here are a useful guide for clinicians also. More information about the book is given at the end of this article.
If you remember only the 5 questions discussed in this chapter when you finish this book, its purpose will have been fulfilled. Keep them in mind and refer back to them as you read the rest of this book. They form the basic toolkit that will help you put into practice many of the things that we suggest.
1. What will happen if I wait and watch?
2. What are my test or treatment options?
3. What are the benefits and harms of these options?
4. How do the benefits and harms weigh up for me?
5. Do I have enough information to make a choice?
Depending on the severity of your illness, and whether your practitioner has satisfied you that he or she practises evidence-based health care, you may not need to explore the quality of the evidence behind the answers to the first 3 questions. But if you do feel the need to validate the evidence to these questions, you will find the necessary techniques to do so in Part 4 of this book—“Evaluating the evidence.”
1. WHAT WILL HAPPEN IF I WAIT AND WATCH?
A few years ago Lewis Thomas, an influential and thoughtful essayist on scientific matters, wrote that the dilemma of modern medicine, and the underlying central flaw in medical education, is the irresistible drive to do something.
There is a natural temptation for consumers and health professionals alike to assume that, if something is broken, they should try to fix it. But many conditions are self-limiting—you will recover …
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