Roger Soll, MD and Eric Gibson, MD
In this segment, “When Evidence and Practice Diverge,” Dr. Roger Soll and Dr. Eric Gibson offer insights into practice variations in neonatology and the use of therapies that differ from the recommendations presented by authoritative guidelines.
Neonatology is frequently recognized as having been an early entrant into the field of evidence-based medicine. Despite decades of work in evidence-based practices, we continue to see a gap between what is evidence proven and what are actual practices. Dr. Soll explains that this gap is not necessarily that the evidence is not appreciated, but that some clinicians may choose not to incorporate certain practices because they believe the evidence does not apply to their population of infants. Specifically, Dr. Soll addresses such practices as fungal prophylaxis, antenatal steroids for premature infants at the margins of viability, and prophylactic indomethacin therapy. The future of evidence-based medicine therefore likely lies in improving communication and developing insight into how to best apply new data in order to provide more cohesive, standardized care.