scholarly journals Scientific evidence based medicine: myth and reality of variability in clinical practice and its impact on health outcomes

2009 ◽  
Vol 26 (1) ◽  
2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior

ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required.


2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?


Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick

Evidence-based medicine (EBM) is an effective tool for identifying and critically appraising quality research findings, and allowing the best to be integrated within clinical practice. EBM requires familiarity with evidence grading systems, key statistical methods, and requires a good understanding of how to review and critique scientific papers to guide the clinical practice. This chapter introduces these tools and provide an easy-to-use layout for reading academic papers in hand.


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