The COVID-19 pandemic has pushed health care to the forefront of public attention and interest. And thanks to the global race to find a vaccine, people are focused on the science of medicine as well. One term you're likely to encounter is "evidence-based medicine," or "evidence-based care." A universally accepted definition is hard to come by, but many experts cite A.L. Cochrane in his seminal work, Effectiveness & Efficiency, from 1972.
He wrote:
Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factor.
Put more simply, Brian Haynes of McMaster University describes evidence-based health care as "the transfer of research results into practice."
Using the results of research to design treatment plans is only part of the equation. The results of a practitioner's own experiences also come in to play. And perhaps most often overlooked is the need for a dialogue between a patient and their health care provider, in which the patient plays a part in decision making based on their own preferences and values. This is known as patient activation.
Evidence-based care is a broadly agreed-upon objective, but it is not universally practiced. Usually, this is a result of factors beyond the health care setting. Long-standing cultural or even medical traditions can sometimes inhibit the advancement of evidence-based medicine. For example, for decades, stroke patients were widely treated with calcium channel blockers. It took a comprehensive review of all available research in 1999 to determine that the treatment showed no evidence of a beneficial effect. Politics can play a part as well. In an interview with the World Health Organization (WHO), leading Africa health researcher Charles Shey Wiysonge noted that evidence may lead to conclusions that run counter to what a government believes. "Sometimes, policy-makers ignore the evidence because it’s not what they want to hear," Wiysonge said. "There are many examples of unspeakable and unnecessary suffering resulting from the failure to take an evidence-based approach."
Although the definition of evidence-based medicine may vary, it generally calls for following the latest and most complete medical research as a means to recommend and improve patient care. It should include the input of the patient, and it's important to avoid practices based solely on tradition or subjective personal experience.