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Evidence-based Medicine (EBM)

What is Evidence-based medicine (EBM)? Discussion Essay

Evidence-based medicine (EBM) is a term that refers to the use of the best available scientific evidence to guide clinical decisions and practices. EBM aims to combine the expertise of the clinician, the values of the patient, and the most relevant and reliable research findings to improve the quality and effectiveness of health care.

EBM is not a new concept, but it has gained more attention and recognition in recent years as a way to promote rational and informed choices in medicine. EBM is also a tool for social justice, as it strives to provide equitable care for patients in different settings and contexts.

EBM involves a process of asking clinical questions, searching for the best available evidence, appraising the quality and validity of the evidence, applying the evidence to the specific patient situation, and evaluating the outcomes of the decision. EBM also requires a process of shared decision making, in which the clinician and the patient discuss the benefits and harms of different options, and consider the patient’s preferences, values, and expectations.

EBM is not a rigid or mechanical approach that disregards clinical judgment or patient preferences. EBM is not a one-size-fits-all solution that ignores individual differences or contextual factors. EBM is not a substitute for clinical experience or intuition, but rather a complement that enhances them. EBM is not a way to impose external standards or guidelines on clinicians or patients, but rather a way to support them in making informed and personalized decisions.

EBM is a dynamic and evolving field that constantly incorporates new research findings and methods. EBM also faces some challenges and limitations, such as the availability, accessibility, quality, and applicability of evidence, as well as the barriers to implementation and dissemination of evidence in practice. EBM requires continuous learning, critical thinking, and collaboration among clinicians, researchers, patients, and other stakeholders.

EBM is a valuable and essential component of modern medicine that can improve health outcomes, reduce unnecessary interventions, enhance patient satisfaction, and optimize resource allocation. EBM is also a mindset and a culture that fosters curiosity, inquiry, and improvement in health care.

References:

: Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2. https://www.bmj.com/content/312/7023/71
: What is EBM? | BMJ Best Practice. https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-ebm/
: Guyatt G, Rennie D. Users’ guides to the medical literature: A manual for evidence-based clinical practice. 3rd ed. New York: McGraw-Hill Education; 2015.
: Lavis JN, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 1: What is evidence-informed policymaking? Health Res Policy Syst 2009;7(Suppl 1):S1. https://health-policy-systems.biomedcentral.com/articles/10.1186/1478-4505-7-S1-S1
: Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: How to practice and teach EBM. 5th ed. Edinburgh: Elsevier; 2019.
: Elwyn G, Frosch D, Thomson R et al. Shared decision making: A model for clinical practice. J Gen Intern Med 2012;27:1361-7. https://link.springer.com/article/10.1007/s11606-012-2077-6
: Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: A quarter century on. Lancet 2017;390:415-23. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31592-6/fulltext
: Greenhalgh T, Howick J, Maskrey N; Evidence Based Medicine Renaissance Group. Evidence-based medicine thesis: A movement in crisis? BMJ 2014;348:g3725. https://www.bmj.com/content/348/bmj.g3725
: Ioannidis JP. Evidence-based medicine has been hijacked: A report to David Sackett. J Clin Epidemiol 2016;73:82-6.
https://www.sciencedirect.com/science/article/abs/pii/S089543561600016X

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