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Editorials |

Steroids in Acute Exacerbation of Asthma : How Do We Grade the Evidence?

Paul E. Marik, MD, FCCP (Washington, DC); Joseph Varon, MD, FCCP (Houston, TX)
Author and Funding Information

Dr. Marik is Director of the Medical ICU, Washington Hospital Center; Dr. Varon is Assistant Professor of Medicine, Baylor College of Medicine, and Research Director, Department of Emergency Services, The Methodist Hospital.

Correspondence to: Joseph Varon, MD, FCCP, Department of Emergency Services, The Methodist Hospital, 6565 Fannin M 196, Houston, TX 77030; e-mail: jvaron@bcm.tmc.edu



Chest. 1999;116(2):273-275. doi:10.1378/chest.116.2.273
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Extract

The practice of modern medicine is based on our expanded understanding of human physiology and the pathophysiologic basis of disease together with targeted therapeutic modalities that interrupt these pathophysiologic processes. However, it is insufficient to demonstrate that an intervention alters the disease process without demonstrating an improvement in patient outcome. The randomized clinical trial (RCT) has, therefore, become the reference in medicine by which to judge the effect of an intervention on patient outcome, because it provides the greatest justification for conclusion of casualty, it is subject to the least bias, and it provides the most valid data on which to base all measures of the benefits and risk of particular therapies. Numerous ineffective and harmful therapies have been abandoned as a consequence of RCT studies, while other therapies have become integral to the care of patients and have become regarded as the “standard of care.”

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