Evidence-Based Health Care
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Introduction
Evidence-based health care (EBHC) is the inegration of individual clinical expertise with the best available clinical evidence.
EBHC, and indeed all health care, needs to be viewed within the context of a patient's beliefs, values, culture, etc and health concerns.
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There is a BMJ article describing how there is no evidence parachutes save lives.
Some people call evidence-based health care 'pharmaceutical-based research'. While this may be too cynical, it is important to guard against industry-sponsored publications and the accompanying evidence-based bias.
There is an EBHC cycle, where by
- form questions
- search
- critically appraise
- apply clinically
- evaluate performance
Start with a good question and roll.
It is important to be a good consumer of clinical research; doing clinical research is less important.
One of the biggest things is deciding on whether published evidence fits the patient. Research is often done in highly selected samples that do not usually reflect the realities of who gets sick,
Another even bigger thing is how to communicate evidence to patients to enable them to make informed choice.
Evideince-based health care is important, but so are health care based studies that seek to include clinical realities and the difficulties that are associated with it.
Fit EBHC within narrative based health care. Cause really, it's the unfolding of people's lives that matters most.
Resources and References
Towards Optimized Practice (Alberta)
Intuition and Evidence - Uneasy Bedfellows? - British Journal of General Practice, 2002
Narrative-Based Medicine in an Evidence Based World - BMJ 1999
Resources and References
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