Tutorial

Medicine & Evidences

The clinical decision process used into cancer diagnosis and treatment is based on evidences. Papers published in peer-review journals create sustained grades of recommendation. The most accurate data comes from randomized clinical trials and metanalysis. When browsing the following icons, you will better understand the clinical decision process.

  • Oncology is a medical specialty whose knowledge is systematized. Medical knowledge can be divided into standard and experimental. Standard knowledge means the one already globally recognized as the best option available at the moment. Experiential knowledge is a technical and ethical well-designed project that might or might not be useful, since it is still in a trial phase.

  • Not always the new is the best. When it comes to innovation, many people understand as something already fully tested and safe. Unfortunately, there is still no clear medical meaning for the terms new or innovation. Sometimes, what is called innovation or discovery is sustained only on basic research, not supported by clinical trials and therefore not entirely evaluated in its effectiveness or risk. For a better orientation of the patients, the media should restrict the terms new, innovation or discovery in medical science only to describe a diagnostic or therapeutic intervention already clinically tested and accepted as a better option than the standard one. This is the methodological and correct way to replace a previous less efficient diagnostic or therapeutic intervention.

  • The physician is the only professional qualified to judge and guide the patient into a standard or experimental cancer treatment. The decision process requires very specific knowledge, often discussed in many international scientific meetings, requiring continuous updating. The right treatment's recommendation is the most important step in achieving the specific disease's expected outcome.

  • The clinical oncologist knows how to categorize medical knowledge in levels of evidence, which is very important for the safety of the recommendation. These levels of evidence are presented in cancer diagnosis, staging, treatment and prevention. There are international classifications that categorize the levels of evidence. They are based on the type of clinical trial, its methodology and statistical power, which will define a degree of recommendation.

  • Medical knowledge is universal. When a scientist describes a new method of cancer diagnosis or treatment, he immediately sends it for publication, preferably in a peer review journal. Prospective randomized clinical trials allow the comparison between the new and the standard treatment. This beautiful methodology usually produces a scientific production chain reaction. Doctors should be constantly updated, attending international scientific meetings or trough the reading of specialized medical journals. Each recommendation given to the patient should be supported by its scientific publication in a well-recognized peer-review journal.