Evidence Based Medicine – A Personal Opinion
The moment we take on an obligation and responsibility to care for and serve every individual; we have to bring a mastery of clinical skills and must understand the valid diagnostic evidence with patient’s expectations. In order to do so, we must constantly practice self-directed learning to keep pace with the changing trends and advances in the world of medicine.
As a Research Medical Officer on a General Medicine ward, I often question myself and seek evidence for different treatment plans that the doctors develop for each patient. When I graduated and earned the doctor of pharmacy degree, I was quite sure that I will implement my knowledge and refine my skills to benefit fellow humans.
The idea and concept of evidence based medicine has been very old; however it got massive attention in 1992 when the sudden interest in this particular field was observed. Since then the number of articles published on evidence based medicine has increased from one publication to about 1000 articles in 1998. The reason is probably due to our everyday need and requirement to develop a valid tool for the tricky diagnosis, prognosis, therapies and prevention and not to deny the fact that a doctor’s inability to spend more than required time to find and integrate this evidence.
Evidence based medicine is the amalgamation of the best research evidence along with an equal balance of clinical proficiency and patient standards. Here, the terminology ‘best research evidence’ is used to define the clinical research that is purely focused on patients. The idea behind evidence based medicine is to bring new evidence by the help of clinical research so that the previous diagnostic tests and treatments are substituted by a validated new, safer and improved one.
In order to fulfill the aim of converting the signs, symptoms and history of patient into therapeutic alliance, we need to know that the learning and practice of evidence based medicine starts and ends with patients. The clinical needs of these patients function as a device to detect our knowledge essentials so that we can concentrate on searching evidence about a patient’s problems and eventually demonstrate the incorporation of this evidence with knowledge and patient inclination.
Now the important question is ‘Whether evidence based medicine does or does not improve health care consequences for patients’?
Previously conducted randomized trials have shown that due to contamination and sample size problems arising, it was difficult to provide valid evidence about this advancement. Besides, there are several ethical fears like concealment of access to evidence from the control clinicians. The outcome of evidence based medicine has been a bitter sweet symphony up till present reports; the conclusion may be that there are basically three major limitations that are universal to science/medicine:
1. Lack of coherent scientific evidence
2. Struggle to implement any evidence on patient health
3. Obstacles in the way of high quality medicine
About the author: Rakhshinda Mujeeb is a doctor of Pharmacy from Baqai Medical University, Karachi, Pakistan. She is currently working as a research associate at the Aga Khan University Hospital, Karachi, Pakistan, in the Department of Internal Medicine. She can be reached at: [email protected]
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