Evidence-based medicine (EBM) is the conscientious integration of current clinical research evidence by healthcare professionals when making decisions concerning patient care. Only "best evidence" criteria can be used in practicing evidence-based medicine, i.e., information culled from valid, peer-reviewed research studies designed to investigate diagnostic testing accuracy, the predictive strength of prognostic elements and the results of various health care techniques.
Additionally, EBM encourages meaningful conversation between physicians and their patients so that everyone shares in making preferred, critical health care decisions. Instead of the doctor singularly making and executing decisions about a patient's treatment program, EBM advocates both provider and patient discussing a course of action and deciding whether this is a mutually satisfying resolution.
Practicing evidence-based medicine also entails the evaluation of comparative clinical investigations offering strong evidential reinforcement for making decisions over clinical expertise and/or mechanistic interpretation. Although advocates of EBM understand the value of clinical expertise, they argue that "expertise" needs to be supported by higher order, self-sufficient evidence.
Emerging from the positive experiences of those who practice evidence-based medicine is the field of evidence-based public health (EBPH). With limited funding for public health care, increasing rates of infectious diseases and the growing awareness of science-based interventions, EBPH provides pragmatic strategies necessary to address serious population health issues. Tools available for meeting the needs of evidence-based public health practices are free online resources for policy tracking, systematic reviews and U.S. health control/surveillance. The same key elements used in practicing EBPH are used to practice EVM--engaging the patient (community) in decision making, utilizing data systems and making decisions based on the best quantitative/qualitative, peer-reviewed evidence available.
In addition to promoting a reciprocal relationship between patient and doctor, practicing evidence based-medicine is becoming essential for maximizing the objectives of the Triple Aim program. According to Triple Aim design principles, the United States health care system is significantly lacking positive attributes in three areas: patient experience when receiving medical treatment, bettering the health of targeted populations and decreasing the cost of health care (per capita).
Practicing evidence-based medicine to achieve Triple Aim goals means that health care professionals must:
Intuitively plausible and increasingly incorporated into medical school programs, EBM is broadly used to develop guidelines for clinical practices as well as being accessed by clinicians who were once too busy to find and investigate original research independently. In addition, new ways of performing clinical studies (pragmatic vs. explanatory trials, real-world conditions, patient-centered outcomes), are facilitating a paradigm shift from doctor-focused to patient first/doctor second-focused. Proponents of EBM claim that its universal acceptance and use will naturally lead to increased patient conciliation, rigorous diagnoses and robustly corrective treatments.
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