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Letters |6 July 2004

Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding

Kenneth M. Kessler, MD

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  • From University of Miami School of Medicine, Miami, FL 33101.
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TO THE EDITOR:
The recent endoscopy guidelines from the Nonvariceal Upper GI Bleeding Consensus Conference Group (1) illustrate that a single hierarchy of evidence can lead to illogical conclusions. Because endoscopy is supported by level I evidence, it follows that all processes necessary to perform endoscopy equally supported. It is illogical to assign the availability of an endoscopist, support personnel, and the patient (recommendations 1, 2, and 3, respectively) to an inferior position because these recommendations are based on opinion. While opinion may represent the poorest level of experimental evidence, some opinions, for example, those not open to experimental verification...
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Kessler KM. Managing Patients with Nonvariceal Upper Gastrointestinal Bleeding. Ann Intern Med. 2004;141:79. doi: 10.7326/0003-4819-141-1-200407060-00028

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Published: Ann Intern Med. 2004;141(1):79.

DOI: 10.7326/0003-4819-141-1-200407060-00028

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2004 American College of Physicians
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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