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Less is more, now more than ever
  1. Christine Soong1,
  2. Karen B Born2,3,
  3. Wendy Levinson4
  1. 1GIM, Mount Sinai Hospital, Toronto, Ontario, Canada
  2. 2Institute of Health Policy, Management and Evaluation, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
  3. 3Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
  4. 4Deparment of Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Christine Soong, GIM, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; christine.soong{at}

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Our society and health systems have been upended by COVID-19. The search for a magic bullet is desperately being sought by decision makers and the public. Yet, aside from the early availability of a diagnostic test, there remains limited evidence that laboratory or imaging tests can accurately predict clinical deterioration beyond that afforded by basic vital signs. There are currently some therapies undergoing intensive investigation yet remain premature for widespread adoption, leaving clinicians and patients feeling frustrated and helpless. It is precisely at a time of crisis that clinicians should embrace that ‘less is more’ and consider that ‘more’ medical interventions can result in harm to patients and waste of limited healthcare system resources.

Many in the scientific and clinician community have pivoted to focus on a singular goal: advancing evidence on how to care for patients with COVID-19. Importantly, there are voices within the research community urging that the scientific method should not be cast aside due to the urgency of the pandemic.1 Similarly, clinical reasoning and evidence-based medicine should not be disregarded in this crisis.2 Significant harms can arise when practices are adopted without scientific evaluation beyond evidence at the level of case series.3 4

Despite the lack of proven care pathways and diagnostic or therapeutic interventions, there is widespread early adoption …

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