Which specialities are the most empirically-oriented?

[PsychStudent]

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I mean, which look most toward research to inform their every-day clinical practice? And which are least research oriented? Thanks!

 

[dutchman]

I mean, which look most toward research to inform their every-day clinical practice? And which are least research oriented? Thanks!

I will take a guess while I bump this for you. I will say pathology for your first question, and primary care for your second.

BTW, does anyone know which specialties has the most studying during residency?

 

[McDoctor]

I would guess that primary care is one of the least evidence based in practice, simply because of the broad scope of conditions one is expected to treat and the lack of good data for some of these commonly encountered problems. There are a myriad of different ways to approach functional abdominal pain, chronic daily headache, tension headaches, and chronic muskuloskeletal pain syndromes in general, none of which have good data to guide your therapy.

I'd say, in my experience, Psychiatry seems to be least evidence based. I always see psychiatrists doing their own thing and prescribing off-label meds with little data to support their efficacy.

As far as most evidence based, I'd probably say it is in a field with a very narrow focus. Like, for instance, radiation oncology.

 

[Apollyon]

Studying? I would think that radiology and radiation oncology would be up there, if only because they have to take physics boards, which implies knowing physics, and that leads to my tautology: physics sucks, and physics is life; therefore, life sucks.

 

[radonc]

radiation oncology is very evidenced based, much more so than medonc or surg onc. i would say that cardiology is also very evidenced based. not sure about other specialties though...

 

[andros]

I think hematology/hem-onc is very research/evidence medicine based. I agree that psych is probably one of the least EBM based (or I'm just ignorant 🙂 ).

 

[Winged Scapula]

I think hematology/hem-onc is very research/evidence medicine based. I agree that psych is probably one of the least EBM based (or I'm just ignorant 🙂 ).

I agree - I work closely with our medical oncologists and they are very involved in active research protocols, reviewing current literature and basing treatment plans on those.

 

[radonc]

i never said medonc was not 'very evidenced based'...just that radonc was a bit more evidenced based...

 

[bigeyedfish]

There is less evidence based practice in pediatrics. It's hard to ethically do studies on kids.

 

[gutonc]

There is less evidence based practice in pediatrics. It's hard to ethically do studies on kids.

In a similar vein, OB is probably one of the least evidence-based practices out there, simply because nobody wants to be the one to introduce the next thalidomide to the world.

My wife is pregnant and, with my encouragement, is currently enrolled in 3 different research protocols, only one of which involves taking anything (Vitamin C/E supplements which have been proven safe in pregnancy vs. placebo in preventing pre-eclampsia). The other two are mostly social survey things w/ questionaires every couple of visits. This is at an academic medical center w/ a pretty research oriented OB program.

By the admission of many OB lecturers I've heard over the years, most of the advances in survival of premature births has come from the neonatologists, not the OBs.

Clearly there is a lot of evidence-based stuff going on in the infertility/REI world and in the neonatology setting but those 9 (hopefully) months in-between are pretty far behind.

Having said all that, pregnancy is not an illness so perhaps treating it like one is the wrong thing to be doing anyway.

 

[Winged Scapula]

i never said medonc was not 'very evidenced based'...just that radonc was a bit more evidenced based...

True...and I did not mean for you (or anyone else) to think that. I will agree that med and rad onc are more evidence based than surg onc, but we are doing pretty well (ie, partial mastectomy + radtx vs mastectomy being the classic).