Question

EBM represents the judicious use of clinical evidence in making decisions about individual patient care Supporters of EBM argue that its integration of best research evidence, physician expertise and patient values makes it an ideal model for guiding clinical practice. They also suggest that it reduces variation among clinical practices, discourages the use of unproven interventions, and brings consistency to clinical guidelines. Critics of the approach, however, suggest that EBM prioritizes experimental evidence over pathophysiological presentation, case-specific histories, and clinicians' observational expertise. They argue that EBM skews the autonomy of the doctor-patient relationship by limiting the patient's ability to choose which treatment is best for their unique circumstances. They also argue that EBM clashes with the framework of many culturally-oriented, traditional approaches to healthcare." Do you agree or disagree with evidence-based medicine?

Answer 1

David Sackett, the “father” of evidence-based medicine (EBM), stated that EBM is “the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients”. EBM helps to avoid ineffective Therapies.

The answer to the question “Do you agree or disagree with evidence-based medicine?” for the particular patient case can be arrived only after answering the following questions:

1. Does the study represent people similar to the specific/particular patient?

2. Does the study cover the aspect of the problem that is most important to the particular patient?

3. Does the study suggest a clear and useful plan of action?

Once the teleconsultant can answer all three of these questions affirmatively, then he can decide whether he should proceed or not with EBM for the selected patient.

Thus we can conclude EBM is not a “cure for all” nor it is “cook book for medicine.” Physicians must also use their clinical judgment when evidence is lacking or when whose medical problem may not fit exactly into the question assessed in the research study.