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Evidence-Based Medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.
Evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in more thoughtful identification and compassionate use o f individual patients predicaments, rights, and preferences in making clinical decisions about their care. By best available external evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests ( including clinical examination), the power of prognostic markers, and the efficacy and safely of therapeutic, rehabilitative, and preventative regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with the new ones that are more powerful, more accurate, more efficacious, and safer. Good doctors use both individual clinical experience and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients.
Evidence-based medicine is neither old-hat nor impossible to practice. The argument that everyone already is doing it fails before evidence of striking variations in both the integration of patient values into our clinical behavior and in the rates with which clinicians provide interventions to their patients. The difficulties that clinicians face in keeping abreast of all the medical advances reported in primary journals are obvious from a comparison of the time required for reading with the time available.
There are Evidence-based medicine courses given in the medical schools. Current clinical journals have routine sections devoted to it. There is a journal called "Evidence-based medicine". Commercial summaries are being sold by astute vendors and are available to our libraries.
If you have comments or suggestions, email me at amangino@sbhcs.com
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Location: First
Floor Across from the Physician Lounge
Hours: Open and staffed weekdays,
8:30AM to 4:30 PM
Librarian: Arlene Mangino,
MLS, MA
Phone: 973-450-2294
Fax: 973-450-1936
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