Searching for Evidence in Neonatology.

Evidence based medicine has changed clinical practice by incorporating data from randomized controlled trials (RCTs). While some biases in RCTs are well recognized, we discuss some less acknowledged. Selection bias may arise in the consent stage. Industry funded studies more often report a positive outcome. Post-hoc changes of outcome measures and other mis-reporting lowers the reliability of outcome data. Finally even the GRADE system retains subjectivity. CONCLUSION: Moving from "intuition" into "evidence based" medicine involves grappling with several pitfalls. These pose challenges for authors, editors, reviewers, and readers. All require vigilance before drawing conclusions from presented data.