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Trends in medicine: What is evidence-based medicine?

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News accounts of the latest medical research are hard to miss with coverage in magazines, newspaper health sections, radio, and television. While some of these studies may seem arcane, many are the basis for knowing which medical treatments are effective for patients and which are not. To actively participate in health care decision making, consumers need to understand how healthcare professionals are making treatment decisions.

Doctors and health care professionals are attempting to help patients make sense of the overload of health information by gathering, evaluating, and sharing well–tested, proven medical research. This process of bringing the best available evidence from scientific research to patient care is known as evidence-based medicine (EBM). The emphasis with EBM is on applying research to medical care: when there is evidence that a treatment works and benefits the patient, it is practiced; where there is evidence that a treatment has not benefited the patient, is ineffective, or harmful, it is not practiced; and where there is not enough evidence, healthcare professionals should proceed carefully.

 

Many patients are educating themselves about their health, self-diagnosing, and pursuing care on their own.

Some patients are using health information to self-diagnose their conditions and asking doctors to prescribe treatments based on their own research, others are confused by the overload of health information.  To improve health outcomes, doctors and patients should share the responsibility for making health care decisions.

  • Patients are bringing in articles and ads and self-diagnosing specific conditions. This presents an opportunity for doctors and patients to discuss the patient’s actual situation and make appropriate decisions based on shared information.
    • Pharmaceutical ads are a major source of tension because they tell patients to ask the doctor for certain prescriptions by name without knowing if it’s appropriate. Doctors should take the time to explain to patients why the drug is or is not appropriate for them and then discuss other treatment options as well.
  • Doctors can start the dialogue to help patients sort out their questions and concerns.
  • Learning about medical treatments from friends, family and co-workers is a significant source of information that is credible to patients.
  • Often times, patients feel they know what is wrong before seeing a doctor and the challenge is communicating this knowledge to the doctor.
  • Doctors who disagree with their patients’ diagnosis or do not provide them with the desired treatment are often criticized. Shared decision making helps avoid disagreements and leads to successful patient outcomes.

 

All of the health information now available to consumers is changing the patient/doctor relationship.

Patients’ increased access to medical information is changing the relationship between patient and health care professional.

  • Patients have access to more medical information than ever before through magazine articles, advertisements and online searches, and health care professionals can play a critical role in helping patients differentiate the good from the bad.
  • More patients are taking more responsibility for their own care and want doctors to be partners, not bosses, in this relationship.
  • As America becomes more diverse, we need to pay special attention to cultural, linguistic, and economic barriers that may inhibit consumers from getting the information they need to make appropriate health care decisions.

 

To help doctors and patients make treatment decisions, it is necessary to sort through health information and find the best medical treatment based on what has been proven to work and is effective.

Many doctors and other health care professionals are attempting to help patients make sense of the overload of health information by gathering, evaluating, and sharing well-tested, proven, medical research.  With this research, the health care professional and patient make treatment decisions together based on what works and is effective.

  • Health care systems are working towards a decision-making process incorporating medical research evaluation along with good stewardship - if there is evidence a treatment works and benefits the patient, it is practiced; if there is evidence a treatment has no benefit or may harm the patient, it is not done.  In cases where there is insufficient evidence about a treatment or if evidence doesn’t exist, a consensus is developed among health care professionals and they proceed carefully.  It is a shared decision-making process between patient and doctor.
  • Your doctor uses clinical judgment, incorporating the best research, his/her knowledge and experience, to present you with treatment options.
  • Making decisions based on what has been proven to work helps ensure that you and your health professional choose the most effective and beneficial treatment for you.  Understanding what works most effectively helps spend your health care resources wisely and benefits everyone.

 

Ask your doctor or other health care professional about how you can decide together what is the best medical treatment for you.

Patients and doctors need to engage in a dialogue about making the best medical treatment decisions.

  • Health care providers are working at bringing together the best available information about health care practices to create and implement programs that help people live healthier lives.
  • Health care providers have created specific care management programs for many diseases, including diabetes, asthma, congestive heart failure, coronary artery disease and depression.
    • Health care professionals stay up-to-date by using a computer system of well-tested medical research that can be used right in your doctor’s office.

 

Additional Resources about Evidence Based Medicine

To learn more about making health care decisions based on the best medical evidence, check the following resources for quality health information:

Cochrane Consumer Network.  This Web site is part of the Cochrane Collaboration, an international organization that aims to review all healthcare evidence and publishes the reviews electronically. The consumer network website summarizes the reviews for consumers.

MEDLINEplus at www.medlineplus.gov has extensive health information for consumers from the National Library of Medicine and the National Institutes of Health.

The National Committee for Quality Assurance (NCQA) consumer Web site at www.healthchoices.org explains how to choose a health plan based on quality. Includes a Health Plan Report Card.

Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) website at www.jcaho.org has information on the quality of care at your local health care facility.  JCAHO evaluates the quality and safety of care for health care organizations.

Kaiser Permanente’s Care Management Institute, www.kpcmi.org, establishes care management programs for patients based on the best available evidence.

To learn more about evidence-based health care and how healthcare professionals are making treatment decisions, Check out the online course developed by CUE (Consumers United for Evidence Based Health Care) on Understanding Evidence Based Healthcare: A Foundation for Action.

About this Web page

These messages were developed by the NCL, in partnership with Kaiser Permanente, to educate consumers about the concept of Evidence-Based Medicine. For more information, contact NCL's health policy team.

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