Sachin Dave wrote:
>
> 1. Patient characteristics affecting the use of evidence based
> medicine ( e.g. 1. patient not being treated with ACE inhibitors for
> hypertension and coronary artery disease ina diabetic is his or her
> intolerance in form of cough or other side effects 2. Patient
> prefering to buy a less expensive medication than a better
> pharmacologic alternative 3. Patients percieved intolerance (not real
> intolerance) ... so on and forth).
>
Sachin, you seem to be out of track here. To my knowledge, the process
of EBM consists of i) defining a relevant and answerable clinical query
(using your experience and expertise) ii)evaluate the evidence around
the possible answers, and iii) apply the result with your patient,
according to his/her preferences and values. Therefore, provided that
the patient was properly involved, none of your examples above is in
fact conflicing with the good practice of EBM.
cheers,
Piersante Sestini
Institute of Respiratory Diseases
University of Siena
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