What is Evidence-Based Medicine?
Defined, evidence-based medicine is the cumulative result of a synthesis of clinical expertise, patient’s values and the best scientific evidence we have available relative to that patient’s care. Evidence-based medicine (EBM) originated in the second half of the 19th century and represents the conscientious use of the best evidence available in making reasonable decisions about patient care.
Gaps Between Research and Practice in Medicine
One of the biggest shortcomings of using EBM is the gap between the release of scientific studies and their adoption by the clinical community. It represents a huge knowledge gap and a barrier to the implementation of the EBM model. For example, in the case of the beneficial use of aspirin in the treatment of heart attack victims, it took almost a decade for it to become a routine practice after the EBM studies were released.
Interestingly, the publication of COVID-19 articles are bypassing some of the usual publication rules and are going right into the search engines. This is to specifically reduce the gap between research and practice, an endeavor much needed in this pandemic.
Classification of Evidence
EBM classifies evidence based on their freedom from biases in the interpretation of the results. The levels of evidence look something like this:
1. Evidence obtained by a meta-analysis of several randomized controlled research (RCR).
2. Evidence from a sole RCR.
3. Evidence from one well designed controlled RCR.
4. Evidence from one quasi-experimental approach.
5. Research case study only.
6. Evidence from one’s clinical practice or case studies.
Each level represents a strength of evidence to ponder in application to a patient’s case or to a public health situation. With EBM a provider can assess the strength of evidence with the risks/benefits of ordering tests and treatments for an individual patient or the strength of evidence for a public health recommendation. We are said to be in an age of EBM.
Five Ways Evidence-Based Medicine Adds Value to the Functional Health Model
1. EBM helps functional health providers stay on top of standardized treatment protocols without reading 17 studies a day by utilizing study classification and priority.
2. Uses timely data to make decisions. This has been greatly aided by the computer age and the development and maintenance of large databases of information that providers can access for research and education.
3. It improves accountability, transparency, and worth. What this means is the patient acquires the best care for the least cost with all variables of the treatment consistent with the values of the patient.
4. Improves the quality of care. Despite the fact that Americans spend more money on healthcare than any other nation in the world, we are the sickest.
5. Improves outcomes. Functional health providers are invested in practicing medicine that works, not just seeing patients on a daily schedule and taking care of urgent ills. They want to see that a prescribed treatment has true value for a patient and that the care received has made a significant impact on that patient’s overall health and well-being.
Functional health represents a fusion of EBM and alternative medicine. It has been argued that functional health practitioners are not evidence-based practitioners. That cannot be further from the truth. Functional health practitioners frequently rely on EBM for treatment decisions and novel approaches to diseases that are on the cutting edge of scientific decisions and novel approaches to diseases.
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