I attended the latest DUETs meeting yesterday and was delighted to see the progress being made. Iain Chalmers and Muir Gray refer to the National Therapeutic Ignorance Service – highlighting the significant number of uncertainties in clinical practice.
Perhaps the most significant development will be the move, for DUETs, into the National Knowledge Service and close links with the NLH’s specialist libraries. Muir was very strong in his support for highlighting uncertainty/ignorance. It may be too soon to hope that clinicians will enthusiastically embrace uncertainty, but things are beginning to change.
So DUETs will continue , highlighting and recording ignorance as it grows.
My involvement started around 2 years ago with a meeting with Iain to discuss the ATTRACT service and unanswered questions. I highlighted my favourite unanswered question – what is the optimal frequency of vitamin b12 injections in pernicious anaemia? In the UK these are given every 3 months and in North America it is typically monthly. However, there is no trial evidence to support either position. Still no answer to that Q though…..