In his 1971 publication ‘Effectiveness and Efficiency’, Archibald (Archie) Cochrane strongly criticized the lack of reliable evidence behind many of the commonly accepted healthcare interventions at the time. His criticisms spurred rigorous evaluations of healthcare interventions and highlighted the need for evidence in medicine. His call for a collection of systematic reviews led to the creation of The Cochrane Collaboration. Archie Cochrane was a visionary person who helped lay down much of the foundation for evidence-based medicine (Ref 2009).
Evidence based medicine (EBM), is a new paradigm for teaching and practice of clinical medicine introduced by the group led by David Sackett in 1992 (Ref 1992). EBM is an evolving discipline that has had a huge impact on the practice of medicine. Evidence based medicine requires the integration of the best research evidence, with the physicians clinical expertise and patients values expectations. (Ref 1995) ‘Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming dictated by evidence. Even excellent external evidence may be inapplicable to or inappropriate for an individual patient. External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients’ (Ref 1995).
Celebrating 25 years of EBM the pioneers who where instrumental in establishing evidence based practice traced the history, explained the true nature and the practice of EBM discussed the problems and barriers and gave the vision for the future (Ref 2014)
Some have argued that although evidence based medicine has had many benefits, it has also had some negative unintended consequences. A support group offer a preliminary agenda for the movement’s renaissance, refocusing on providing useable evidence that can be combined with context and professional expertise so that individual patients get optimal treatment. (Ref 2014)
Books that will help practice of EBM
Testing Treatments – Better research for better healthcare. 2nd Edition – LINK
Smart Health Choices: Making sense of health advice. LINK