This essay aims to evaluate the criticism mentioned above and to see if Evidence-Based Medicine (EBM) is a good approach for clinical decision making. I will explain what EBM is, and its applications and then go on to discuss its strengths and limitations.
What is Evidence-Based Medicine and its application:
EBM is a method of practice in which clinical decisions are made upon the combination of best available evidence and clinical expertise whilst adhering to patient values. [1] Sackett gives the definition as “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” [2]
EBM tries to implement the strongest evidence according …show more content…
EBM gives the clinician a guideline that enables for a more accurate diagnosis and aids in the delivery of effective treatments. Furthermore, the clinical expertise of the clinician is displayed through a compassionate approach to the identification of the issue whilst adhering to the morals of patient values. The combination of the two factors enables for efficient diagnosis and delivery of more effective treatment. [2] In addition to that, observing the guidelines laid out by EBM ensures that treatment is safe hence adhering to the nonmaleficence clause of medical practice. This is because the research provided by EBM is an established strong piece of evidence that in most cases has gone through metanalyses thus eliminating bias. So, in effect the clinician is acting upon a known method of treatment that is most effective according to comprising summary data. Without EBM, clinicians may have to rely on trial and error or conduct own research that could be exposed to a confirmation bias, exposing the patient to …show more content…
This limits doctors in certain complex cases where EBM may not be sufficient enough for treatment. As EBM only utilises averages it does not consider the extreme cases inhibiting options clinicians can take. Adding on to that even if doctors may have a possible method of treatment based upon previous research, it is rejected as it is deemed to be ‘weak evidence’ in comparison to the standards set up by EBM.
Additionally, the RCTs used in EBM research only includes one factor (as is controlled). This approach, as the criticism suggest, may not cater to a patient’s particular case, for example if a doctor put an elderly patient on high dosage treatment without critically appraising the EBM guideline could result in the opposite of the desired effect.
There volume of evidence offered by EBM is too large [7] which results in difficulty in management. Clinicians may have to work with an excess amount of evidence which could become time consuming and hence delay treatment. This could prove to be problematic in treatment as in medicine time is of the essence and even the slightest delays could be