Evidence-Based Medicine

What is the problem Why is there a need for EBM Don›t we already practice
medicine fairly uniformly based on a common fund of evidence.
Bottom line: we are now often practicing medicine based on clinical judgment
that is not well informed by the best evidence of medical research – a slippery
slope to diminished affectivity and/or compromised competence.
Why evidence-based medicine
The first reaction of any doctor to EBM is likely to be «Well, of course that›s
what I always do.» The second response, perhaps more thoughtful and certainly
more honest, will be a degree of confusion: «What does it really mean How
does one actually do evidence based medicine Surely there is not enough
time What kind of doctor am I if my medicine is not evidence based»
Some doctors perceived EBM as diminishing the role of clinical acumen and
experience, fearing that the «art» of decision-making will be lost. It should
be noted that EBM neither excludes the vital role played by experience, nor
advocates the replacement of sound clinical judgment. The practice of EBM
means integrating individual clinical expertise with the best available external
clinical evidence from systematic research. EBM respects clinical skills while
emphasizing the need to develop new skills in information management.
Health care professional of the, whether physicians, nurses, pharmacists or
others, require a basic understanding of steps for seeking out, assessing and
applying the most useful information in concert with patients› preferences.
Although we need new evidence daily, we usually fail to get it. The result is that
both our up-to-date knowledge and our clinical performance deteriorate with
time. Trying to overcome clinical entropy through traditional CME programs
doesn›t improve our clinical performance. A different approach to clinical
learning has been shown to be effective in keeping practitioners up to date:
EBM
The premise of EBM is a simple one, that excellence in patient care correlates
with the use of the best currently available evidence, and that physicians require
a unique set of skills which are not part of traditional medical education, in
order to access and utilize this information.
In EBM, Systematic Reviews are considered the best source of evidence.
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