Evidence based medicine

Davidoff, Frank; Haynes, Brian; Dl, Sackett; Smith, Richard

doi:10.1136/bmj.310.6987.1085

Cited by 527 publications

(186 citation statements)

References 5 publications

(2 reference statements)

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“…The EBM movement centres around five linked ideas: first, clinical decisions should be based on the best available scientific evidence; second, the clinical problem, and not the habits or protocols, should determine the type of evidence to be sought; third, identifying the best evidence means using epidemiological and biostatistical ways of thinking; fourth, conclusions derived from identifying and critically appraising evidence are useful only if put into action in managing patients or making health care decisions; finally, performance should be constantly evaluated (Davidoff, Haynes, Sackett, & Smith, 1995, p. 1085. Evidence-based medical practice purports to achieve these goals by enlisting numerous techniques for the management, evaluation, and application of clinical data into medical practice.…”

Section: Evidence and Evidence-based Medicinementioning

confidence: 99%

On evidence and evidence-based medicine: Lessons from the philosophy of science

Goldenberg

2006

Social Science & Medicine

325

248

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The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920-1950). At the same time, the term ''evidence-based medicine'' has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should be challenged on the grounds of how 'evidence' has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered.The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. r

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Section: Evidence and Evidence-based Medicinementioning

confidence: 99%

On evidence and evidence-based medicine: Lessons from the philosophy of science

Goldenberg

2006

Social Science & Medicine

325

248

View full text Add to dashboard Cite

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“…3 Part of this problem is a well recognised gap between the publication of research evidence and the adoption of this evidence in clinical practice. 4 The delay in uptake of a proven technology can be over a decade. The reasons for this delay are multi-factorial and suggested reasons include inertia, information overload, and difficulty in interpreting contradictory messages.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care, a cluster randomised controlled trial

Bahrami

Deery²,

Clarkson

et al. 2004

Br Dent J

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“…Its practice means integrating individual clinical expertise with clinical evidence from systematic research and its main principle is that clinical decisions should be based on the best available scientific evidence of previous experience and the conclusions based on such evidence should stimulate quality improvements in patient care [1,2]. However, it should be noted that in several areas of the medical sciences the lack of good evidence for clinical decision-making remains an issue and the availability of good evidence does not necessarily get applied to patient care [3].…”

Section: Introductionmentioning

confidence: 99%

Study on management of headache by general practitioners in South Italy

et al. 2005

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IntroductionEvidence-based medicine (EBM) promotes the use of current best evidence in making decisions about the health care of individual patients. Its practice means integrating individual clinical expertise with clinical evidence from systematic research and its main principle is that clinical decisions should be based on the best available scientific evidence of previous experience and the conclusions based on such evidence should stimulate quality improvements in patient care [1,2]. However, it should be noted that in several areas of the medical sciences the lack of good evidence for clinical decision-making remains an issue and the availability of good evidence does not necessarily get applied to patient care [3]. Moreover, as clinicians deal with patients, there is a continuing increase in the need for clinical information, but for many reasons clinicians often do not obtain that vital evidence.Previous studies have assessed general practitioners' (GPs) perceptions of EBM and its influence on health care decisions [8][9][10], but to the best of our knowledge no information is available about its evaluation on migraine and information on this topic is needed because patients with migraine headaches often present family physicians with diagnostic and therapeutic challenges. Therefore, the purpose of the present study is to identify if GPs in Italy are aware of technical terms used in EBM and what their behaviour is in terms of treating patients with migraine. Abstract The impact of migraine headaches is one of the major public health problems in several industrialised countries, with many patients reporting frequent and significant disability. Previous studies have assessed general practitioners' (GPs) perceptions towards evidence-based medicine (EBM) and its influence on health care decisions. Of 500 questionnaires distributed, responses were received from 455 for a response rate of 91%. Respondents' awareness of technical terms used in EBM indicated that only 27.2% of GPs agreed that clinical trials are needed to evaluate the efficacy of treatments and this awareness was higher in those who learned about migraine from scientific journals or continuing education courses and who attended courses on epidemiology or EBM. Training and continuing educational programmes on EBM and guidelines in terms of treatments of headache for GPs are strongly needed.J Headache Pain (2005) 6:312-314 DOI 10.1007/s10194-005-0218-6 Study on management of headache by general practitioners in South Italy H E A D A C H E A N D C O N T I N U I T Y I N H E A L T H C A R E R. Iannacchero (౧)

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Evidence based medicine

Cited by 527 publications

References 5 publications

On evidence and evidence-based medicine: Lessons from the philosophy of science

On evidence and evidence-based medicine: Lessons from the philosophy of science

Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care, a cluster randomised controlled trial

Study on management of headache by general practitioners in South Italy

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