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In reply

In his most entertaining and scholarly letter, Diskin correctly characterizes the study of Roos et al¹ as a randomized, prospective double-blind trial, and he is more than willing to accept its conclusions (in spite of the shortcomings pointed out in my editorial²), while he decries the growing use of practice guidelines. The inconsistency relates to the fact that practice guidelines are generally derived from critical analyses by acknowledged experts of not one but many randomized, prospective, double-blind trials. Thus, the basis for my recommendations is to subscribe to the larger scientific portfolio, whereas to do otherwise would clearly risk being the one "leaving early" from the scientific revolution. As an apparent student of medical history in general, and the writings of William Osler in particular, Diskin might do well to recall the admonition of Osler (that originated with Alexander Pope) to "be not the first by whom . . . [Full Text of this Article]

AUTHOR INFORMATION
Leonard Wartofsky, MD, MACP

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