Traditionally, the treatment of disease has been determined by theory and reasoning from basic sciences. However, more and more research results from clinical trials and observational studies have provided appealing “evidence” that many medical professionals may refer to, or even rely on, over the basic sciences, in their practice.
What is Evidence Based Medicine?Such reliance on research findings in treating medical conditions is collectively called evidence based medicine. Nevertheless, like any system that affects the general population, evidence based medicine has its pros and cons. This requires researchers, medical professionals, and patients to pay close attention to just how evidence based medicine is utilised.
What are the goals of Evidence Based Medicine?Understanding and applying evidence based medicine can easily become clouded, but knowing the goals of true evidence based medicine may help eliminate some confusion. Evidence based medicine:
- Prioritises ethical healthcare for the patient
- Stresses presentation of evidence that is understandable to both doctors and patients
- Follows judgment of experts over established rules
- Discusses treatment options and decisions with patients
- Cultivates strong doctor-patient relationships with humanistic care
- Expands these goals to the community in support of greater public health
When Evidence Based Medicine falls short…Despite the straightforward nature of its goals, evidence based medicine contains several loopholes that damage patients’ quality of care. Here are some problem areas:
- Special interest group bias Companies that produce pharmaceutical drugs or medical devices drive research interests and ultimately define what qualifies as disease. For example, an agency that makes drugs to reverse baldness in men will urge scientists to study male baldness. And those research results may convince the public that male baldness is a serious medical condition.
- Too much information While a large supply of evidence may prove that evidence based medicine is effective, it also deters from its influence. The average research study contains a great deal of quantifiable data that must be both illustrated and explained resulting in hundreds if not thousands of pages of reading!
- Blurred lines between risk and disease Evidence based medicine inevitably poses a number of statistics on healthcare that medical professionals cannot ignore. Thus, a 74-year-old woman may be prescribed a statin drug and subjected to tests to see if she has a cardiovascular condition all because research shows that women aged 70 to 75 are at an increased risk of heart disease.
- Dependence on computerised systems Thanks to evidence based medicine, healthcare has become computerised and can be a lot like trying the fit a square peg into a square hole—every symptom must fit. As a result, if a patient suffers from diabetes, but complains of a symptom that is not related to diabetes then his or her doctor may disregard or fail to document that symptom.
- No answer for multiple conditions Although evidence based medicine can provide valuable insight into treating a disease, it really does not have an answer for patients that suffer from multiple diseases. Consequently, treating one disease based on evidence may make other diseases worse leading to chronic polypharmacy (taking multiple pharmaceutical drugs).