Sir: The controversy over giving albumin to seriously ill patients ("Thousands killed by burns `cure'", 24 July) highlights the difficulty in routinely applying the "scientific method" to medical situations. This approach is effective when used for patients with isolated problems, such as bacterial infection, diabetes or most surgically treatable diseases. However, the complex multi-organ system disorders of patients in intensive care means that many different treatments have to be used at the same time, thus preventing true, scientific control of all the variables which could affect outcome.
The report also raises a general question about the nature of evidence that doctors use. Is it acceptable to use the pragmatic, qualitative evidence of clinical experience, or should we use bogus scientific, quantitative rigour that erroneously proves the effectiveness of one particular therapy given in combination with many others? Indeed, there are lies, damned lies and evidence-based statistics.
DR C BROWN
General HospitalReuse content