Physiology versus evidence-based guidance for critical care practice

Luciano Gattinoni, Eleonora Carlesso, Alessandro Santini

Research output: Contribution to journalReview articlepeer-review


Evidence based medicine is an attempt to optimize the medical decision process through methods primarily based on evidence coming from meta-analyses, systematic reviews, and randomized controlled trials ("evidence-based medicine"), rather than on "clinical judgment" alone. The randomized trials are the cornerstones of this process. However, the randomized trials are just a method to prove or disprove a given hypothesis, which, in turn, derives from a general observation of the reality (premises or theories). In this paper we will examine some of the most recent randomized trials performed in Intensive Care, analyzing their premises, hypothesis and outcome. It is quite evident that when the premises are wrong or too vague the unavoidable consequences will be a negative outcome. We should pay when designing the trial an equal attention in defining premises and hypothesis that we pay for the trial conduction.

Original languageEnglish
Article numberS7
JournalCritical Care
Publication statusPublished - Dec 18 2015

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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