Evidence Based Medicine: Definitions, Examples and Opinions: Medical Education


BABAOĞLU M. Ö. , Yasar U., DOST T., Kayaalp S. O.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.29, no.5, pp.1298-1305, 2009 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 5
  • Publication Date: 2009
  • Title of Journal : TURKIYE KLINIKLERI TIP BILIMLERI DERGISI
  • Page Numbers: pp.1298-1305

Abstract

Evidence based medicine (EBM), which has gained popular interest since 1970s aims to incorporate current best evidence from systematic medical research into clinical application. The strategy used in EBM serves to support therapeutic decision making together with the physician's clinical experience and patient's choices. The methodology of EBM adopts the evaluation of the latest clinical research, particularly the outcomes of the well-designed randomized controlled clinical trials and meta-analyses and to select the most efficacious interventions maximizing the quality and quantity of life for individual patients. In practice of EBM, the accurate definition of the diagnosis and the therapeutic problem is most critical. Subsequently, the relevant evidence to answer the structured questions specific to individual patient's problems is sought for in the medical literature via electronic databases. Among the criteria to be considered in decision making are the efficacy and safety of therapeutics as well as the power of evidence. The statistical parameters, such as relative and absolute risk reductions and number needed to treat or number of the patients harmed per life saved may help in concluding on a certain therapeutic decision. There is some criticism against EBM. Most opponents advocate that evidence based treatment approach disregards the financial consequences and raises the cost of health care. Others are concerned about publication bias for positive results in medical literature or the possibility of generalizing treatments when trial findings may only be applicable to a narrowly-defined spectrum of patients. These arguments should be kept in consideration while using the EBM approach.