The reasons why I'm FOR evidence based medicine

The reasons why I'm FOR evidence based medicine

by Saadia Aziz Dhedhi -
Number of replies: 5

Evidence based medicine is providing, what is thought to be, optimal clinical practice on the basis of clinical research and sysatematic reviewing.

And precisely for this reason, surely patients should feel 'at ease' that they are being treated according to previously tested and reviewed interventions.

If a patient enters the doctor's room, they expect a diagnosis with associated treatement, and by following guidelines produced by EBM, the patient feels re-assured that they are being managed correctly.

EBM comes with even more benefit specifically for those countries with no working framework or guidelines, EBM can bring routine and a solid basis on which to treat patients. It provides a good 'algorithm' to follow with known results.

By using EBM, you are advocating the most 'up to date and safe medical practice, and with specific guidelines to follow there is the added benefit of health care cost reduction, for e.g. as doctors will not be prescribing wasted drugs, or patients will not be sent for unnecessary tests.

Lastly, If you have and know there is good evidence available for a particular patient with a disease, then would it not almost be unethical, to ignore/avoid the EBM with regards to interventions for that patient?

In reply to Saadia Aziz Dhedhi

Re: The reasons why I'm FOR evidence based medicine

by Patricia Greenhalgh -

This is a good 'general' argument Saadia but can you think of any particular cases where it falls down in practice?

In reply to Saadia Aziz Dhedhi

Re: The reasons why I'm FOR evidence based medicine

by Deleted user -

Hi Saadia,

i think you have raised some useful points regarding EBM.My only concern is you concluded by saying 'if  there is good evidence available for a particular patient'.I find it difficult to accept that you will have evidence on the effectiveness of a treatment prior to its usage in a patient.Like i posted on Sara's link EBM is bout generalization telling you your proabilities but not any assurances that the said result will be met or not in a particular patient.Is that not what professional judgements seek to do ?


In reply to Saadia Aziz Dhedhi

Re: The reasons why I'm FOR evidence based medicine

by Deleted user -

Hi Saadia, yes, i also agree that patients would feel more comfortable that they are being treated according to previously reviewed and tested treatmentws/interventions.

re-assurance is an important emotion to feel.

I also feel that EBM provides an organized structure for treating patients.

In reply to Saadia Aziz Dhedhi

Re: The reasons why I'm FOR evidence based medicine

by Joseph Daniel Jameson -

Saadia, I disagree with your statement that ‘EBM comes with even more benefit specifically for those countries with no working framework or guidelines’. I think that this is unlikely as the evidence base is built up of evidence from trials and other research mainly carried out in high-income countries. Evidence from this research may not be applicable to populations of low or middle income countries. So, guidelines from one country may not provide the ‘solid basis on which to treat patients’ you claim in a different country.

Also, Tahir informed me (I have not had time to confirm this) that current health reforms in the NHS have led to those publishing guidelines to change stance. NICE, for example, is now a corporate body and is looking to sell and export its guidelines overseas. This is likely to make it harder for low income countries to obtain guidelines and when they do, they may not be applicable to their patient population.

In reply to Joseph Daniel Jameson

Re: The reasons why I'm FOR evidence based medicine

by Tahir Mir -

Joe, I disagree with your comment on low income countries finding it difficult to obtain guidelines and when they do, they may not be applicable to their patient population. Last year NICE ran a workshop in Hyderabad, India. The programme included NICE guideline development methods and adaptation of the processes to their local healthcare system. This demonstrates that the practice of evidence based medicine can be shared beyond transnational borders in a context which is applicable to the demopgraphics of local populations.

www.nice.org.uk/aboutnice/niceinternational/projects/Hyderabad.jsp#tabs-nohdr