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What is the Definition of Evidence-Based Medicine?Let's begin with the definition from Oxford's Evidence-Based Medicine Website http://cebm.jr2.ox.ac.uk/ebmisisnt.html#coredef. "Evidence-based medicine is the conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine requires the integration of individual clinical expertise with the best available external clinical evidence from systematic research." These are the left and right arms of the practitioner. External clinical evidence has a short doubling-time, and 1) invalidates previously accepted diagnostic tests and treatments and 2) replaces them with new ones that are more powerful, more accurate, more efficacious and safer. Good doctors use clinical expertise and best evidence. Neither is enough. Without clinical expertise, practice becomes evidence-tyrannized, external evidence may be inapplicable or inappropriate for an individual. Without best evidence, practices become out of date.
Clinical evidence can inform, but can never replace clinical expertise. Clinical expertise decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision.
Some fear that evidence based medicine will be hijacked by purchasers and managers to cut the costs of health care for individual patients When directed toward the benefit of individual patients, evidence-based medicine identifies and applies the most efficacious interventions to maximize their function, quality and quantity of life and "may raise rather than lower the cost of their care." |
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Community-Based
Teaching Benefits - Strategies for Teaching in a Busy
Practice Page last updated:
February 24, 2003
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Evidence
Based Medicine is NOT "cookbook medicine"
