Doesn't it depend on how you define worked? If you are talking about the individual observations of a practioner, I think it would be acceptable under certain circumstances to say the intervention worked, without double blind studies. You send a woman with level 8 pain to an ENT to clip a tongue tie and with one swift procedure the woman drops to level 0 pain, you can say that on some level the intervention worked. Can you say whether she would have eventually dropped to level 0 pain without the intervention...nope. Can you assure the next woman that you see that it will work for her...nope. But can you say that it worked if you achieve the goal that you were shooting for... I believe you can. And when you talk about tongue clipping in the absence of studies, is it acceptable to say "in my practice 50 or 75 or 90% of the dyads I see with this problem are helped by this particular procedure" I think yes yes yes...that is the beauty of having experience. The more you do the more you observe the more you have to offer....but I think it is also important to always let them know this is your own empirical evidence, your opinion, your data...there are no studies to back up what you are saying (if of course that is true that there are no studies). You will generally have more experience than the woman you are working with and that is what she is counting on, but you need to be honest and let her know what is opinion and what is fact.

Kathy Lilleskov RN IBCLC (hitting my posting limit for the first time ever!!!! will shut up now :)  )

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