Evidence-based medicine

White, KerrL.; Fowler, P.B.S.; Bradley, F. H.; Field, Jenny; Iggo, Neil; Norman, G. R.; Hughes, John D.; Chagla, Leena; McCulloch, Peter; Aveyard, Paul; Dl, Sackett

doi:10.1016/s0140-6736(95)91651-2

Cited by 22 publications

(14 citation statements)

References 14 publications

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“…How much mainstream medical care is based on the best available scientific knowledge about what does or doesn't work? Claims that only 10%–20% of care was based on good evidence were made by a few influential people such as Kerr White (a US physician who pioneered the discipline of health services research) and Archie Cochrane (the UK epidemiologist who provided inspiration for the Cochrane Collaboration) in 1976, 1 and by David Eddy (a leading US health policy expert) in 1991 2 . These statements were repeated in widely read publications such as the US Office of Technology Assessment reports 3 , 4 and the BMJ 2…”

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confidence: 99%

Gaps between best evidence and practice: causes for concern

Buchan¹

2004

Medical Journal of Australia

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Overseas studies that aim to quantify the evidence base of conventional medical care give varying estimates, but many of these studies have potential for bias. We do not know how much of the total healthcare Australians receive is based on the best available evidence; studies of a number of specific conditions show that there are gaps between what is known and what happens in practice. The National Institute of Clinical Studies aims to identify and test systemic approaches to embed ongoing review and uptake of evidence into routine clinical care.

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confidence: 99%

Gaps between best evidence and practice: causes for concern

Buchan¹

2004

Medical Journal of Australia

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“…In particular, there was concern about the quality of much clinical research, with poor design and inadequate sample size being among the major factors (Fletcher & Fletcher, 1979). A government report estimated that no more than 10% to 20% of medical procedures in use had been evaluated in properly controlled clinical trials (Office of Technology Assessment, 1978; for comments on this estimate, see White, 1995). And there was continuing controversy over scientific and ethical aspects of randomized clinical trials.…”

Section: An Overview Of Biostatisticsmentioning

confidence: 99%

Outcomes Research and the Quality of Health Care:

Miké

1999

Eval Health Prof

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Beyond the dazzling achievements of high-technology medicine, the spiraling cost of health care and lack of access for many have long been the subject of national debate. Driven by the interaction of powerful economic forces, managed care is now taking over the health care system, while there is growing popular interest in alternative medicine. But amid the changing structures and financial incentives, much uncertainty still remains concerning the safety and effectiveness of medical interventions. The author, a mathematical scientist engaged in medical research and education for more than 30 years, has proposed the "ethics of evidence" as an approach to medical uncertainty, to be adopted as a vital component of biomedical ethics. The ethics of evidence comprises two imperatives. The first imperative calls for the creation, dissemination, and use of the best possible scientific evidence as a basis for every phase of medical decision making. Complementing it, the second imperative focuses on the need to increase awareness of, and come to terms with, the extent and ultimately irreducible nature of uncertainty. After a brief sketch of the genesis of this concept, the ethics of evidence is further explored here in the context of current outcomes research, the focus on quality of health care, and related problems of contemporary medicine.

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“…It would almost seem as if references are given with the belief that they will never be read. A member of the original health advisory panel to the US Congressional Office of Technology Assessment (White 1995) ventured that 10±20% of treatment was not evidence-based and challenged others to provide better evidence than that to which he referred. The paper which was purported to support his statement which he repeatedly cited for over a decade was a survey conducted by a research worker on the prescriptions written by 19 general practitioners over a 2-week period.…”

Section: Evidence-based Medicinementioning

confidence: 99%

Evidence‐based everything

Fowler¹

1997

Evaluation Clinical Practice

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Academic medicine often seems to be swayed more by fashion than science. Establishment team consensus is only needed where there is ambiguity. Evidence-based medicine is a new term for informed decision making and facilitated learning is purported to do away with authoritarian indoctrination. Problems that arise from the emphasis on team decisions, evidence based medicine and facilitated learning are discussed.

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Evidence-based medicine

Cited by 22 publications

References 14 publications

Gaps between best evidence and practice: causes for concern

Gaps between best evidence and practice: causes for concern

Outcomes Research and the Quality of Health Care:

Evidence‐based everything

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