Evidence-based psychiatry: pride and prejudice

to medical training, but also to clinical practice, research activity, health care management, pur chasing and policy making. The proponents of EBM point towards an ever larger gap between research findings and clinical practice, as doctors are increasingly unable to keep up with vast amounts of new information. New technology can be used to bridge that gap. Instead of advocating a form of treatment because of tradition, clinical intuition or deference to a senior colleague, a doctor may go to a computer and look up the available research evidence. The Idea is very attractive. Doctors are kept up-todate in their practice, they continuously educate themselves, and patients receive the best treat ments. Similarly managers, purchasers and health politicians can make informed decisions based on an increasingly sophisticated database. The development of guidelines and protocols, enforced via the lever of contracting, may be seen as "bringing order into the chaos of widespread variations" in clinical practice (McKee & Clarke,