Evidence is often insufficient to answer questions in clinical practice. In an effort to fill these “gaps” between clinical investigation and daily conundrums, practicing rheumatologists use experience, logic, pathophysiology, individual patients and collegial consultation. In order to capture this science of clinical practice, a group of European and American clinicians and clinician investigators worked in investigative teams or Study Sections, each devoted to utilizing the science of clinical practice to address and critical clinical questions in Rheumatoid Arthritis, Imaging, Vasculitis and Gout that are inadequately answered by published evidence. Conclusions were summarized by a method of debate and discussion. It is anticipated that by defining uncertainty and using such an analytical and experiential method, rheumatologists can assist themselves in solving problems in their daily practice.