Current issues of ACP Journal Club are published in Annals of Internal Medicine


From research evidence to context: The challenge of individualizing care


ACP J Club. 2005 Mar-Apr;142:A14. doi:10.7326/ACPJC-2005-142-2-A14

To the Editor

Dr. Weiner's editorial on the challenge of individualizing care (1) highlights an important point that has been neglected, for the most part, in the medical literature. The enthusiasm for evidence-based medicine (the jargon is “best evidence”) has obscured the fact that Weiner emphasizes so well. Contextualization, which he defines as the process of identifying factors specific to a patient's life situation and relevant to their care, is essential in the practice of internal medicine. It is what all practitioners must do to be effective and efficient.

The emphasis on quantitation above all else spills over into other disciplines (2); we must make sure that we do not neglect all aspects of our patients' lives in our single-minded pursuit of statistical significance.

Irwin J. Schatz, MD
John A. Burns School of MedicineUniversity of Hawaii
Honolulu, Hawaii, USA


1. Weiner SJ.From research evidence to context: The challenge of individualizing care. ACP Journal Club. 2004 Nov-Dec;141:A11.

2. Schatz E, Schatz IJ. Medicine and political science: parallel lessons in methodological excess. PS: Political Science & Politics. 2003;36:417-22.