Chinese Medicine - Modern Practice (252 pages)

Developing an Evidence-Based Curriculum in TCM 219
16.2.3 Evidence-based medicine
Evidence-based medicine (EBM) has become popular in relatively recent
times in western medicine and increasingly guides clinical practice. Sackett
and colleagues provide a useful definition of EBM: “Evidence-based
medicine is the conscientious, explicit and judicious use of current best
evidence in making decisions about the case of individual patients. The
practice of evidence-based medicine means integrating individual clinical
expertise with the best available clinical evidence from systematic
research” (Sackett et al., 1996: p. 1). Systematic scientific evidence comes
in many forms including randomised clinical trials, meta-analyses, cross-
sectional studies, individual case studies and basic (laboratory) research.
Rosenberg describes EBM as “an approach to clinical problem solving, a
means of determining rational practice, a method of integrating service
with training and education, a way of generating research ideas and, in
summary, best practice made explicit and accessible” (Rosenberg, 2001 :
p. 1). It may also be a way in which to resolve health economic issues
through elimination of practises that are not effective (Rosenberg, 2001).
If Chinese medicine is to become accepted by the western medical
community, it will need to be scmtinised in the same way that western
medicine is.
There are many reasons for applying the EBM approach to Chinese
medicine. It is not for the purpose of justifying itself to the western
medicine fraternity, though this may well be an effect: it is to explore the
medicine in as many ways as possible in order to understand and develop
Chinese medicine further. Chinese medicine is not flawless nor has it
reached its full potential. Development of an evidence base to which
scientific research contributes will not only help guide clinical practice,
but may also help bridge the understanding of the human including health
and illness between western and Chinese medicine.
Putting Chinese medicine under the microscope and studying it
according to the best scientific principles can produce useful information
that can help guide clinical practice and provide a level of justification
for particular clinical treatments, including the prescription of particular
herbal medicines and acupuncture prescriptions. Research may provide a
scientific basis for further development of Chinese medicine theory (Tang
and Wong, 1998). Chinese medicine treatments shown to be effective