Thanks, Federico - I agree with questioning the "based" part of EBM. That's why the patient values part is so often lost - and in truth, it seems to me to be cobbled onto the EBM definitions to try and ameliorate the problems that the term itself brings because of implying evidence should be the sole basis of practice. The "patient values" part is a modifier of the definition of EBM, in a way - unless we're defining evidence so broadly as to include values and everything else as evidence, and I don't think that's what anyone in EBM means about that. That's trying to find where evidence fits in practice, and that it is a fundamental aspect of practice, but it cannot be all that there is. For all its flaws, it seems we're stuck with the EBM acronym now. A bit like Kentucky Fried Chicken, when "fried" started to be seen as a bad thing - how do you keep the brand consciousness and awareness, while hiding its problems? Stick with the acronym that you can fly on the flag and be recognised (KFC) and change the bits that no longer work - that seems to be what we have done. This analogy might be mystifying to people who live in countries where KFC is still called Kentucky Fried Chicken - so apologies for that! The same thing appears to have happened to the journals who want to keep their brand recognition while sounding more international (eg BMJ, not British Medical Journal, JAMA and so on).
Hilda
= = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
Hilda Bastian
Ressortleiterin Patienteninformation - Erstellung & Methodik
Head of Department, Patient Information and Research
Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Institute for Quality and Efficiency in Healthcare
Dillenburger Str. 27
D-51105 Köln, Germany
tel: + 49-221 / 35685-401
fax: + 49-221 / 35685-1
mobile: + 49-151 / 1720 4858
email: [log in to unmask]
http://www.iqwig.de <http://www.iqwig.de/>
________________________________
Von: Evidence based health (EBH) [mailto:[log in to unmask]] Im Auftrag von Federico Barbani
Gesendet: Freitag, 27. Mai 2005 09:08
An: [log in to unmask]
Betreff: Re: What is the alternative
quite late ...
Medicine is medicine.
Medicine HAS to be (best available) Evidence Based.
Evidence is not the only base for Medicine.
what about it?
dr. Federico Barbani
Health Purchasing Unit
Health Authority Modena
via San Giovanni del Cantone n. 23
41100 MODENA - Italy
tel. 059/435813 - 435313
fax 059/435703
----- Original Message -----
From: Gareth Morgan <mailto:[log in to unmask]>
To: [log in to unmask]
Sent: Wednesday, May 25, 2005 9:53 AM
Subject: What is the alternative
Hi
I have been a member of this mailbase for quite a while and would like to start a debate about definitions. I finally decided to look for a definition of evidence based medicine and this is one I came up with.
* Evidence-based medicine is a medical movement based upon the application of the scientific method to medical practice, including long-established existing medical traditions not yet subjected to adequate scientific scrutiny. According to the Centre for Evidence-Based Medicine, "Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."
* en.wikipedia.org/wiki/Evidence_based_medicine <http://www.google.se/url?sa=X&start=0&oi=define&q=http://en.wikipedia.org/wiki/Evidence_based_medicine>
The definition is what I expected and seems to be quite obvious but the problem I have is what is the alternative to EBM - myths and legends, old wives tales? Surely all medicine/medical practice (in my limited understanding) should be based on evidence and "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." . Am I missing something here, being a heretic or is this a case of "the kings new clothes"?
Most reports seem top take it for granted that there is an mass/group understanding of what it is all about.
Grateful for responses
With best wishes,
Gareth
http://www.ki.se/biomedlab
e-mail [log in to unmask]
Tel +46 8 5858 1038
Fax +46 8 5858 7730
Gareth Morgan MPhil MSc FIBMS,
Department of Histo/cytopathology, Laboratory Medicine (Labmed),
Karolinska Institute,
Karolinska University Hospital at Huddinge, F46
SE 141 86 Stockholm
Sweden
OBS! Besöksadress: F-Huset, Forskningsgatan 2 F52, Rum 2.10. Laboratoriet för klinisk patologi och cytologi.
NB! Visiting address: Building F, Research Corridor 2 F52, Room 2.10. Clinical Histo- and Cytopathology Laboratory.
