Epilepsy and evidence-based medicine: a vote of confidence in expert opinion from the National Institute for Clinical Excellence?

• Published in: Developmental medicine and child neurology 2005-03, Vol.47 (3), p.204-206
• Main Authors: Ferrie, Colin D, Livingston, John H
• Format: Article
• Language: English
• Subjects: Adult; Annotation; Child; Drug Industry; Drug Resistance; Epilepsy; Epilepsy - diagnosis; Epilepsy - drug therapy; Epilepsy - etiology; Evidence; Evidence-Based Medicine; Freedom; Guidelines; Humans; Meta Analysis; Narcotics; Outcome Assessment (Health Care); Patients; Practice Guidelines as Topic; Professional Competence; Quality Assurance, Health Care; Randomized Controlled Trials; Randomized Controlled Trials as Topic; Research Support as Topic; Seizures; State Medicine; Statistical Significance; United Kingdom
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1017/S001216220500037X

In the UK, guidelines on the management of childhood epilepsy have just been published by the National Institute for Clinical Excellence (NICE). These, it is claimed, are evidence based. One definition of evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Surely, no one could question that this is a good thing and that it should be the cornerstone of our clinical management of patients with epilepsy. The NICE guidelines contain almost 200 recommendations. In addition, NICE has previously published guidelines on the use of the newer antiepileptic drugs (AEDs) in children and the Cochrane database of systematic reviews includes many on the topic of epilepsy. If there is so much evidence around on which to base our clinical practice, why does it seem that most practitioners involved in the clinical care of children with epilepsy base most of their practice on case reports, anecdotes, and personal experience?