Les non-recommandations dans le traitement de l'arthrose et de la polyarthrite rhumatoïde, ou pourquoi la médecine basée sur le niveau de preuve ne s'applique pas (encore) à la rhumatologie

The speed with which the phrase "Evidence-Based Medicine" has entered our
language has been astonishing. Virtually all medical areas are concerned, but it
probably applies best when clearcut diagnosis can be made or when mortality or
well-defined morbidity are the outcomes, two conditions not really frequently
encountered in rheumatology. We will discuss why rheumatology is probably not
ready yet for the concept and will systematically review why "Evidence-Based
Medicine" could in fact be "evidence-biased medicine". We will emphasize why
evidence-based medicine can not replace the personal experience and knowledge of
patients, two major corner-stones in the clinician's daily work, but should
simply be an access to scientific data for the benefit of both patient and
physician.