tailieunhanh - Báo cáo khoa học: "Patience and change: a conflict of interests"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Patience and change: a conflict of interests? | Available online http content 10 5 422 Letter Patience and change a conflict of interests Manoj K Saxena and Peter JD Andrews Department of Intensive Care University of New South Wales St George Hospital Gray Street Kogarah NSW 2217 Australia Corresponding author Manoj K Saxena manojandchris@ Published 19 September 2006 Critical Care 2006 10 422 doi cc5034 This article is online at http content 10 5 422 2006 BioMed Central Ltd See related commentary by Friedrich et al. http content 10 3 145 While we must applaud industry and the Recombinant Human Protein C Worldwide Evaluation in Severe Sepsis PROWESS investigators 1 for the tremendous effort and time expended in their multicentre international study caution needs to be exercised before deciding to make the intervention of activated protein C APC a standard of treatment 2 . We like many others have chosen to introduce APC into our practice in the treatment of severe sepsis despite having an awareness of the progress of associated controversies 3-5 . By choosing to change our practice we may have exposed patients to occult harm or to benefit. Alternatively patient outcome may have remained unchanged but time money and clinical effort have been expended and wasted in the necessary activities to affect the change. These activities are a significant burden on the multidisciplinary team that carry out intensive therapy and their effects should not be underestimated. What impels us to change then Why do we not have more patience and either wait for agitate or participate in the need for more data Perhaps we feel a desire to demonstrate that we are up to date that we are dynamic and that we can implement change quickly and effectively locally We may assume that this is what colleagues as well as the public expect of us. Guidelines from learned bodies 6 may also influence us. In a world that is apparently moving forward rapidly we do not want to feel that we are .