The readings cover the topics of evidence-based medicine, its benefits and limitations, and teaching it to medical students. In particular, evidence-based medicine is defined as “a way of combining the best available scientific evidence, the practitioner’s clinical judgment, and the patient’s values to make medical decisions”. (Ismach, p. 1) On the one hand, evidence-based medicine is viewed as effective way of treatment of all health problems, whereas, on the other hand, such medicine is viewed as old and not worthy of attention.
Of course, the best available evidence should be incorporated into clinical decisions. (Belsey & Snell, p. 1) The evidence-based medicine (EBM) process encompasses the following steps: to raise a clinical problem or issue; to construct a clinical question; to select proper resources for conducting search; to evaluate the validity of evidence; to integrate the evidence with expertise; and to evaluate the performance with the patient. (Clark, p. 4) Many scientists argue that evidence-based medicine is modernization of old principles of medicine, science and probability.
Further, the EBM was pioneered by Gordon Guyatt, David Sackett and Brian Hayens. The effectiveness of the EBM depends on abilities to raise questions based on patient’s problems and to apply the information to the patient’s case. (Ismach, p. 1) Analysis The topics covered in the readings contribute significantly to medical field as they encompass modernization of medicine and science, enhancement of old principles and working out innovative treatment methods. I think that the issue of evidence-based medicine should be paid more attention because it offers effective ways of health problems treatments.
Further, evidence plays important role in clinical decisions, and it should be viewed as a part of clinical expertise. The EBM gives medicine an excellent opportunity to combine research evidence with patient’s problems and optimal clinical decisions. (Carney, p. 231) Of course, the attitudes towards the EBM are different – proponents argue that the EBM is treatment to all health problems, whereas opponents claim that it is simply a new name to old practices. (Ismach, p. 2) The EBM integrates patient’s values, clinical expertise and the best available evidence for finding proper solution to patient’s problem.
Clinical skills, cumulated education and experience are required. Of course, the evidence can’t make proper decision for the clinician, but it is effective for supporting the patient care process. The EBM increases the chances to find optimal clinical decision. (Carney, p. 232) The key challenge is that the EBM requires additional skills as, for example, efficient literature-searching and abilities to apply rules of evidence into clinical expertise. Thus, it is very likely that the EBM lacks specialists and professionals because it requires lifelong and self-directed learning.
(White, p. 51-53) The key benefit of the EBM is that it promotes developing clinical questions and relating them to specific problems of the patients instead of simply reviewing journals for necessary articles. (Carney, p. 232) Moreover, the EBM is patient-oriented meaning that the clinical outcomes are developed to meet the patient’s needs and problems. Recent studies show that the EBM ensure better access to information changing, in such a way, management decisions of patient care. One limitation is that sometimes it is rather difficult to get access to the available evidence.
Summing up, despite certain limitations and criticism, the EBM offers new approach to medicine that stresses the importance of integrating evidence into clinical expertise.
References
A Primer on Evidence-Based Clinical Practice. (2003, July). Power Point Presentation. Belsey, J. , & Snell, T. (2001, May). What is Evidence-Based Medicine? Retrieved January 10, 2009, from httt://www. evidence-based-medicine. co. ua Carney, Stuart. (2005, November 26). Competences for the Foundation Programme – Part III: Evidence Based Medicine.
Career Focus, pp. 231-232. Clark, Nancy. (2009). Intro to Evidence Based Medicine Resources. Power Point Presentation. Dawes, M. G. Decision Analysis. Power Point Presentation. Retrieved January 10, 2009, from http://treeage. com Ismach, Richard. (2004). Teaching Evidence Based Medicine to Medical Students. SAEM Medical Student Educator’s Handbook, pp. 1-7. White, Brandi. (2004). Making Evidence-Based Medicine Doable in Every Practice. Family Practice Management, Retrieved January 10, 2009, from http://www. aafp. org/fpm