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NICE should not intervene where there is equipoise by virtue of insufficient evidence
  1. R K Mohindra
  1. Correspondence to R K Mohindra, 63 Newlands Road, High West Jesmond, Newcastle upon Tyne, NE2 3NT; raj.mohindra1{at}

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To the Editor: Shaw D and Conway DI1 correctly identify that a fact neither proved nor disproved lies at the heart of both Pascal's wager and the National Institute of Clinical Excellence (NICE) guidance in relation to the use of antibiotic (abx) prophylaxis for infective endocarditis (IE). The no lose argument is no match winner for NICE because cardiologists are all too keenly aware that antibiotics kill as surely as IE.

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  • Linked articles 200766.

  • Additional reading Mohindra RK. A case of insufficient evidence equipoise: the NICE guidance on antibiotic prophylaxis for the prevention of infective endocarditis. JME 2010 (in press).

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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  • PostScript
    D M Shaw D I Conway