"Read not to contradict and confute; nor to believe and take for granted; nor to find talk and discourse; but to weigh and consider."

So said Francis Bacon and in a nutshell, it summarises what evidence based medicine and EURECA is all about. I read with interest the article on role of CRP in predicting bacterial infection with fever(1) and the accompanying editorial(2) in the February 2008 issue. I welcome this initiative of Indian Pediatrics and agree with them on "tailoring evidence from the western world" to make it relevant in the Indian context. But this is only half the story. These evidence based reviews not only give useful information to the reader but should also serve to enhance the skills of the person doing the review. Besides improving patient care, this would lead to a gradually increasing number of Indian doctors having a good knowledge of searching medical literature, critically appraising studies and developing the art of writing reviews. This is a resource in short supply(3). A further spin off could be improving one’s biodata by getting some publications and who knows some of them may end up being Cochrane reviewers. Archimedes, the evidence based section of the Archives of Diseases in Childhood has shown to be an educational experience for the reviewers(4) and by active participation of the readers of Indian Pediatrics, similar outcomes can be achieved. For this to happen successfully, there may be a need of guidance from Indian Pediatrics on how to carry out such reviews, a list of possible topics which need addressing in the Indian context (e.g., nimuselide versus paracetamol or ibuprofen in control of fever) and support of a group of clinicians and researchers with experience in evidence-based work who could mentor first time reviewers.

A small clarification also needs to be made regarding the evidence based reviews in the Archives of Diseases in Childhood. These are based on "best available evidence" and are not limited to randomised controlled trials or meta-analysis as these are often not available or feasible. In such a scenario, the next best evidence in the hierarchy of evidence(5) becomes relevant.

R S Arora,
Cancer Research UK Pediatric and
Familial Cancer Research Group,
Royal Manchester Children’s Hospital, Stancliffe,
Hospital Road, Manchester M27 4HA, UK
Email: [email protected]