In Defence of Extrapolation but not Improvisation in SARS-CoV-2 Lung Disease
Recently, the struggle against COVID-19 by respiratory and intensive care clinicians worldwide was punctuated by the sound of calls from a number of influential publications for an end to, as it were, improvisation and a return to principles of evidence-based medicine. The message was that management of SARS-CoV-2 lung disease needed to be guided strictly according to established dogma in acute respiratory distress syndrome unless supplanted by clinical trials specific to COVID-19. This position is predicated on the assumptions that knowledge about acute respiratory distress syndrome, and only about that entity, is directly translatable to SARS-CoV-2 lung disease, and that clinical trials enrolling COVID-19 patients will be completed in a sufficiently timely and rigorous fashion to influence empirical practice during the current pandemic. Clearly, there is room for an alternative perspective. In this Viewpoint, we aim to articulate a contrary point of view by resorting to arguments that are likely to resonate with frontline clinicians battling COVID-19.
Epelbaum, O., & Galperin, I. (2020). In Defence of Extrapolation but not Improvisation in SARS-CoV-2 Lung Disease. Breathe, 16 (2), 200113-200113. https://doi.org/10.1183/20734735.0113-2020