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What's New
- EBM is the conscientious, explicit and judicious use of current bet evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (Sackett)
- Evidence should not be used as a political instrument to justify access restrictions.
- The ultimate evidence is patient outcomes. These outcomes need to be determined based not just on medical results but also on the patient's judgment of how the health intervention has affected his/her of life.
- The pros and cons of different therapies may also vary depending on the patient's other medical conditions. There may be trade offs between effectiveness and safety, or between effectiveness in treating the medical condition and quality of life. (Rodwin, Marc-Politics of Evidence Based Medicine)
- Flawed conclusions interrupt effective patient care and pose potential life threatening consequences to individuals who are most vulnerable. (APA, NAMI, NMHA)
- For many conditions and populations there are no clinical studies available. An absence of evidence, however, does not mean there is an absence of differences among medications and populations.
- Available clinical studies may have been done on patient populations with different demographics, characteristics and co-morbidities than the individual seeking treatment.
- EBM is flexible, not rigid or restrictive and must have the input of various stakeholders, including patients and consumers.
- Burdensome regulation drives a wedge between doctors and patients and may ultimately drives up costs when the "required" therapy does not work.
- The lack of public input in the development of evidentiary questions will skew research questions and resulting analyses will be unlikely to take into consideration all issues relating to interchangability, tolerance, adherence and outcomes that have greater priority for patients than for policymakers. True patient needs may not be addressed.
- A true measure of effectiveness is not simply efficacy but the sum of efficacy plus tolerability in an individual.
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