When there is Confusion and Conflicts - Ask Delphi!

Controversy is an inseparable component of clinical medicine. Unlike in physical sciences, paradoxes and perplexities cannot be completely eliminated from biological sciences. The principal reason for this is the innumerable number of known and unknown co-variables that are sometimes difficult to control. Therefore modern clinicians bewildered by the contradictions often resort to several tactics that help them to overcome the “doctors’ dilemma”. These are broadly classified, in decreasing order of credibility, as Evidence Based Medicine (EBM), Clinical Guidelines and Consensus Statements. The innate growth potential of children, particularly that of newborn, adds the most difficult and dynamic dimension to the complexity of existing co-variables. No wonder that pediatric surgery remains a field full of contradictory opinions and disagreements. Surprisingly guidelines and consensus statements, which are very useful in resolving clinical disputes, are sparingly published in this specialty [1-5] and even the existing ones are of very poor quality.[6] This article is aimed to draw the attention of pediatric and neonatal surgeons to the usefulness of these conflictsolving tools.