In defense of expert opinion

Evidence-based medicine, centered on the incorporation of evidence from cli nical trials and systematic reviews into he teaching and practice of clinic al medicine, explicitly attempts to supplant expert opinion, which is viewe d as an antiquated and unreliable form of medical authority. The epistemolo gy of evidence-based medicine categorizes expert opinion as the lowest form of medical evidence superseded even by methodologically flawed clinical - research. When derived from direct clinical experience, however, expert opi nion represents an alternative-form: of medical knowledge, one that may be complementary to empirical evidence. Input from clinical search and an appe al to alternate forms of medical knowledge edge, including expert opinion, is necessary to overcome the intrinsic gap between clinical research and th e care of individual patients. Even when the quality and quantity of empiri cal medical evidence are ideal, expert opinion ion will remain an integral part of the multifaceted required for the optimal practise of clinical medi cine.