Evidence based medicine and quality of patient care

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Does evidence-based medicine increase the quality of patient care? Why or why not?

Evidence-based medicine is the new arena of medical practice which is being followed and

practiced world over and gaining popularity in health systems where it used to be non-existent.

Evidence based medicine combines the clinical expertise, the patient values and the latest

research recommendations regarding the patients’ conditions into an integrated approach in

handling the patients. It is aimed at increasing the utilization of authentic clinical and medical

research in the decision making process encountered in the clinical setup. Evidence based

medicine demands a set of skills on behalf of the medical practitioner, which includes thorough

literature search as well as application of established rules of evidence in examining the medical

literature.

A recent debate is the impact evidence-based medicine and practice guidelines have on the

quality of patient care. A modified approach to evidence-based medicine has been recently

adopted by many health care providers is the shared decision making strategy in provision of

health care services. Shared decision making means incorporating patient’s values and

preferences into the treatment and diagnoses aspects in conjunction with the evidence provided

by literature, experts around the world and best practices followed globally in this regard.

The process of shared decision making involves providing the patients, access to all of the

information as described above to come up with whatever is best for them. The process needs

detailed education of the patients and their involvement throughout the process from diagnosis to

treatment in order to incorporate their input in finally executing the management plan which is

best for them. Since the patients’ preferences and values differ a lot, shared decision making

leads to variable outcomes for various patients of the same disease. Patient education focuses on

informing the patients about potential benefits of a treatment offered to them, risks that may

accompany following the prescribed course of treatment and the possible outcomes of the

treatments they wish to undertake.

Richard Amerling, M.D., practicing as a nephrologist in New York City apprises of the criticism

being received by the practice guidelines due to a number of reasons. According to Dr.

Amerling, practice guidelines promote a “standardized” model of care and ignore the

individualistic approach to the patient. As a result, the quality of care for the individual patient is

subdued for the broader generalization of care. Furthermore, since practice guidelines cover a

large population to which the physicians following the guidelines cater, an ambiguity in the

guidelines can be supposed to inflict harm to a large number of people.

After mentioning the criticism faced by practice guidelines, Dr. Amerling goes on to explain that

actually is wrong with the guidelines. According to Dr. Amerling, practice guidelines are

completely opinion-based and lack objectivity, they are overly prescriptive which means the

emphasis is on prescribing even in situations which can be managed conservatively, those who

formulate the guidelines are often funded by the industry and as such are prone to be biased in

their recommendations, guidelines are seldom tested thoroughly, target values and reference

ranges often promote over-prescription. Practice guidelines being rigid discourage creative

thinking and research on part of the practicing physicians who find it easy to adhere to the

guidelines and count on the research of others. Dr. Amerling also explains how the research used

to back up evidence-based medicine may be faulty. For most of the researches published and

utilized while formulating practice guidelines, it is more likely for a research claim to be false.

Financial and other interests may also distort the research findings. The claimed research

findings may simply be accurate measures of prevailing bias.

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Does evidence-based medicine increase the quality of patient care? Why or why not? Evidence-based medicine is the new arena of medical practice which is being followed and practiced world over and gaining popularity in health systems where it used to be non-existent. Evidence based medicine combines the clinical expertise, the patient values and the latest research recommendations regarding the patients’ conditions into an integrated approach in handling the patients. It is aimed at increasing the utilization of authentic clinical and medical research in the decision making process encountered in the clinical setup. Evidence based medicine demands a set of skills on behalf of the medical practitioner, which includes thorough literature search as well as application of established rules of evidence in examining the medical literature. A recent debate is the impact evidence-based medicine and practice guidelines have on the quality of patient care. A modified approach to evidence-based medicine has been recently adopted by many health care providers is the shared decision making strategy in provision of health care services. Shared decision making means incorporating patient’s va ...
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