“Clinical decisions should, as far as possible, be evidence based. So runs the current clinical dogma. We are urged to lump all the relevant randomised controlled trials into one giant meta-analysis and come out with a combined odds ratio for all decisions. Physicians, surgeons, nurses are doing it; soon even the lawyers will be using evidence based practice. But what if there is no evidence on which to base a clinical decision?”. That was the incipit of a curious and ironic article by David Isaacs and Dominic Fitzgerald issued more than 20 years ago by the British Medical Journal [1]
