PS If people are looking for a recent paper to convince others of the
folly of using pathophysiological mechanisms as a basis for treatment
decisions this is great; Ebell M, et al. Am Fam Physician 2004; 69:
548-556.
N.
-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Bill Cayley,
Jr
Sent: 30 June 2006 14:26
To: [log in to unmask]
Subject: Why is EBM Important?
Here's my answer - along the lines of the introduction I give our
medical students:
In medicine, we are continually making decisions, and if medicine is to
be a science or a "learned"
profession, we need to think critically about HOW and WHY we make those
decisions. There are a number of potential approaches to making
decisions: 1) Tradition ("we've always done it this way", "my teachers
did it this way"); 2) Convention ("everyone else always does it this
way" - ie, going with the crowd), 3) Belief or Dogma ("I believe the
natural way is best"), 4) "Evidence-based" - that is based on some sort
of systematic assessment of evidence.
Further, I discuss with my students the fact that you can look at
evidence as simply ANY observation about the nature of the world. In the
medical literature, we call a single, isolated instance of something an
"anecdote" (or, if published, a "case report"). If you take a bunch of
observations and group them together, we have a "case series". You can
go on up from there in terms of the rigor, systematization, and
thoroughness of evidence evaluation up to the double-blinded randomized
trial or the meta-analysis.
ALL observations can be considered "evidence" - it's just a matter of
asking what the QUALITY of your evidence is.
So, I see evidence-based medicine as the effort to critically examine
the reasons we do what we do, and the information or evidence that
supports it. In one sense, ALL medicine is "Evidence-Based Medicine" -
it's just that if you practice medicine without thinking critically
about what you do and without looking for high-quality evidence (or at
least the highest quality available) then you are practice medicine
based on very LOW-quality evidence.
Bill C
--- Olive Goddard <[log in to unmask]>
wrote:
> Dear Colleagues,
>
> Here's a question some of you might like to respond to.
>
> All good wishes,
>
> Olive
>
> >>> "Gang Jiang" <[log in to unmask]>
> 29/06/2006 16:16 >>>
>
> Dear Sir/Madam:
>
> I am very interested in evidence based medicine.
> Could you please tell
> me why EBM is important? Can a physician practise medicine without
> knowing EBM?
>
>
> Thank you,
>
> Gang Jiang
>
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Bill Cayley, Jr, MD MDiv [log in to unmask]
Augusta Family Medicine Home Address
207 W Lincoln 3433 McIvor St
Augusta, WI 54722 Eau Claire, WI 54701
Work: 715-286-2270 Home: 715-830-0932
Page: 715-838-7940 Cell: 715-828-4636
|