Evidence Based Medicine

 

Evidence Based MedicineEvidence-based medicine (EBM) is the conscious, deliberate, explicit, judicious and reasonable use of evidence in making medical decisions about the care of individual patients. Evidence-based medicine integrates clinical experience and patient values (patient history) with the best available research information. It includes three components; research-based evidence, clinical expertise and patient values/preferences. Explained in detail here https://www.healthcatalyst.com/5-reasons-practice-evidence-based-medicine-is-hot-topic

Evidence-based medicine started as a movement aimed at increasing the use of high-quality clinical research in clinical decision making. Practicing evidence based medicine does not mean you have a cookbook or manual that you can follow without thinking. Instead, it’s a lifelong, self-directed learning process that aids healthcare givers and clinicians learn from problems and improve on ways they can care for their patients. EBM creates the need for clinically important information and diagnosis, prognosis, therapy, and other clinical and healthcare issues. Evidence-based medicine is more of an improvement on traditional medicine as opposed to it being completely different. As the name implies, it demands more evidence than would traditionally be required or used.

The goals of EBM health practitioners and EBM-Clinicians are: a) to use evidence summaries in clinical practice; b) to help develop and update selected systematic reviews or evidence-based guidelines in their area of expertise; and c) to enroll patients in studies of treatment, diagnosis, and prognosis on which medical practice is based.

In recent years, Evidence Based Medicine has piqued the interest of health professionals and practitioners. A simple definition of EBM is: it’s the conscious and reasonable use of current, best scientific evidence in making decisions in the treatment of each individual. For health practitioners, this is, however, difficult to put into practice. Medical Knowledge grows rapidly and exponentially with new publications and journals constantly being published and previously accepted facts becoming stale and no longer viable it’s hard to keep up. Contributing to this factor is the fact that health practitioners don’t have the time to do as much studying needed to keep up to date on new changes and developments. Hence most doctors simply reviews or brisk through published articles, studies, and medical journals. And if the find the time to read thoroughly, they still lack the time to evaluate the value of the study, its methodology and its transparency. This is one major recurring problem in the practice of Evidence Based Medicine hence doctors are advised to read selectively, make effective selections of what he/she needs and expand on those. This is, however, easier said than done.

Levels of Evidence

When speaking about EDM it’s necessary to classify clinical evidence into levels because all evidence cannot be treated with the same importance. So what are these levels?

Level 1: Evidence in Level I is considered the gold standard of medical knowledge because it comes from randomized controlled clinical trials (RCTs).

Level 2: Evidence from controlled trials without randomization

Level 3: Evidence from cohort or case-controlled analytic studies

Level 4: Evidence from multiple time series i.e observational studies

Level 5: Opinions of respected authorities based on medical experience

Level 6: Evidence based on personal experience (anecdote)

So how can doctors and health practitioners transfer into practicing evidence-based medicine? Health Catalyst lists five steps to transition health organizations into evidence-based medicine

  1. Ask clinicians and doctors to identify a/the key problems
  2. Acquire the best possible evidence and medical knowledge about the problem as
  3. Appraise the evidence i.e see if it’s applicable
  4. Apply the evidence to daily clinical practice
  5. Access performance

So why Evidence Based Medicine? Yes, it’s an improvement on traditional medicine but how does it add Evidence Based Medicinevalue to health systems their performance? Here are some ways EBM adds value to health systems

  1. It helps clinicians stay current on standardized, evidence-based protocols
  2. It uses real-time data to make care decisions
  3. It improves transparency, accountability, and value
  4. It improves quality of care
  5. It improves outcomes all around