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Science is frequently touted as the solution to dryland management problems, yet most management decisions are, by necessity, based primarily on expert knowledge and experience.
Surgical treatment of Charcot arthropathy of the foot and ankle is based primarily on expert opinion.
These recommendations for treatment, however, are based primarily on expert opinion, small non-randomized trials, and short-term trials primarily aimed at demonstrating physiological principles.
Several approaches to insulin regimen adjustments during Ramadan fasting have been postulated in recent reviews, which were based primarily on expert opinion and occasionally on small clinical trials.
However, they are based primarily on expert opinion and what is needed is point-of-care delivery of clinical guidelines and evidence-based recommendations [ 45].
Whereas previously such documents were based primarily on expert opinion, increasingly there is robust evidence generated from licensing studies and clinical trials to support them; the international consensus documents have been supplemented recently to include evidence-based recommendations, and the World Allergy Organization WAOO) has just published an evidence-based guideline 9, 32.
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Although this recommendation is based primarily on consensus and expert opinion rather than empirical evidence [ 38], it is clear that there is a level of international consensus that VBAC requires close vigilance during labor.
The ACOG guidelines also specified that "VBAC should be attempted in institutions equipped to respond to emergencies with physicians immediately available to provide emergency care" [p. 201]; this recommendation, however, was based primarily on consensus and expert opinion, rather than on research evidence [ 9].
Consequently, current recommendations regarding this question are based primarily on clinical experience and expert opinions.
This draft opinion was based primarily on the conclusions of an expert panel evaluation of the existing literature in humans and laboratory animals, although many of the studies included in the review were not considered by the expert panel to be useful for the evaluation.
It follows that the opinions expressed in this review are of necessity based primarily on low-level trial evidence, published expert opinion, and anecdotal personal experience.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com