Thank you, Prof. Cawthorpe!

I agree that there is more to EB practice than just results and I also think it is a matter of ethics.

Best regards,
Luíza

2016-08-25 17:41 GMT-03:00 UoC <[log in to unmask]>:
Dear Luíza,

I think that I understand your plight and there is no easy answer, but here is a possible place to start. I believe that it is a matter of ethics and code.

http://robotics.cs.tamu.edu/RSS2015NegativeResults/pmed.0020124.pdf

Warmest regards,
Prof. Cawthorpe

Sent from my iPad

On Aug 25, 2016, at 2:00 PM, Luiza de Oliveira Rodrigues <[log in to unmask]> wrote:

Dear all,

After a long and exhaustive unfruitful literature search, I write you all to ask for help.

I work with HTA in Brazil. As part of the work of my group, we make some evidence-based clinical guidelines, mainly for the purpose of regulation, in an HMO. The point is, in reply to a guideline proposal, some specialists have questioned the real value of EBM or EB guidelines (specially in the context of hematologic neoplasms), in regard to their impact on patient outcomes or healthcare systems effectiveness and efficiency. 

In short, what is the evidence that evidence-based guideline implementation or evidence-based practice actually changes patient outcomes or healthcare system effectiveness?

I am so convinced of the alleged benefits of EBM and HTA that I never asked myself these questions... I thought, initially, that my literature searches would be obviously answered by solid evidence to confirm my beliefs. That was, however, not the case. It was, nevertheless, relieving that I did not find any evidence in contrary, also. Eventually, I found only one study that directly addressed this question: J Eval Clin Pract. 2015 Dec;21(6):1059-65. doi: 10.1111/jep.12460. Epub 2015 Oct 29. Does evidence-based practice improve patient outcomes? An analysis of a natural experiment in a Spanish hospital. Emparanza JI1, Cabello JB2, Burls AJ3.

Does anyone have more references addressing these issues?

Since I am already bothering you all, I would also like to ask: does anyone have any information about the true amount of medical knowledge that is directly attributable to industry-sponsored research? I often hear the common-sense criticism that most of our current medical knowledge derives from industry sponsored research, and, because of that, we (HTA professionals) should not be so annoyed with the funding source conflicts of interest.

Thank you all.
Luíza