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50 Studies Every Pediatrician Should Know
At the turn of the last century, William Osler, the father of modern medicine
and pediatrics, noted that the practice of medicine is “an art based on science.”
The science, in the late 1890s and early twentieth century, consisted mostly
of anatomy, histology, pathology, and rudimentary microbiology. The medi-
cal literature of the day consisted of anecdotal observations and logical, well-
reasoned treatises. Much of the knowledge of medicine was passed from master
to apprentice and was largely dogmatic in nature.
Beginning in the late 1940s, medical evidence, as we have come to know it,
was born. Beginning with the early trials of streptomycin therapy for tuberculosis and the Framingham Heart Study in the 1940s, the observations of Rammelcamp and Jones linking streptococcal pharyngitis and rheumatic fever, and the Salk polio vaccine trials in the 1950s, the amount of usable, scientifically based, medical evidence has grown at logarithmic rates. If Osler were alive today, he would probably state that the science of modern medicine, while inherently uncertain, is empiric and based on evidence generated by well defined, rigorous methodologies. Unlike the generations of physicians who have gone before, today’s medical practitioners have a wealth of evidence to use as touchstones in all aspects of medical decision-making, enabling all of us to practice a higher quality of medicine and to ensure that, above all else, we do no harm.