On 2/17/2012 7:48 PM, Nino Cartabellotta wrote:
> Who added to the definition of EBM "often from the basic sciences"?
It was Dave Sackett ;-)
Although the sentence should be quoted more in full:
"By best research evidence we mean valid and clinically relevant
research , often from the basic sciences of medicine, but especially
from patient-centered clinical research..."
So, the "often" is actually overrun by "especially".
There are of course numberless occasions when pathophysiological
reasoning complements or surrogate evidence from missing/incomplete
clinical trials, particularly when adapting the evidence to the care of
individual patients.
The simplest example that comes to mind is in choosing the right
antibiotic for an infection in a patient with liver disease (patients
with liver disease are often excluded from clinical trials). Of course
you would prefer an antibiotic that you know from basic science that is
not metabolized in the liver.
The important thing to remember is that pathophysiology is an acceptable
warrant for treatment only when specific clinical evidence is not
available. (in the example above: imagine that an antibiotic has been
proved useful and safe in patients with liver disease, you won't have to
care any more about its metabolism).
But equally important is to remember that without a good grasp of
pathophysiology (background information) is impossible to ask good
clinical questions and to practice decent EBM.
cheers,
Piersante Sestini
>
> -----Messaggio originale-----
> Da: Evidence based health (EBH) [mailto:[log in to unmask]] Per conto di Anoop Balachandran
> Inviato: venerdì 17 febbraio 2012 13:51
> A: [log in to unmask]
> Oggetto: Evidence Based Approach Question
>
> I had a question about EBM. The definition of EBM is" The best available research evidence means evidence from valid and practically relevant research , often from the basic sciences ..."
>
> So can we use just basic science to justify a treatment? Can anyone give an example please.
>
> Thanks.
>
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