Evidence-Based Practice

Ebm Evidence-based practice is a fairly recent paradigm in medicine that places emphasis on applying new skills for healthcare workers such as nurses and physicians that include performing efficient literature searches and applying formal rules of evidence in examining the clinical literature in order to find the best answer to a problem (Evidence-Based Medicine Working Group, 1992). These skills are in addition to traditional clinical skills and understanding patients' emotional needs.

The evidence-based practice represented a shift from old processes used by health care workers such as intuition, unsystematic clinical experience, and pathophysiologic rationale in applying diagnoses or treatments to consumers of healthcare services (Evidence-Based Medicine Working Group, 1992). This particular paradigm shifts in medicine developed due to the increasing use of randomized controlled trials (RCTs) in medicine which were rare up until 1960s and 1970s. RCTs became standard practice for the development of treatments such as medications (Hoffmann, Bennett, & Del Mar, 2010).

If we compare the methods used to diagnosis and treat clinical conditions prior to the evidence-based methods we see that practitioners that the previous approach was characterized by: (1) using unsystematic clinical observations to build knowledge, (2) believing that understanding the basic pathology of disease is a guide for practice, (3) medical training and common sense were believed to allow one to evaluate the efficacy of medical treatments, (4) clinical experience and content expertise were considered sufficient to generate valid guidelines for clinical practice, and (5) a reliance on authority and expert opinions (Evidence-Based Medicine Working Group, 1992).

These techniques are certainly helpful, but evidence-based practice adds: (1) the understanding of the value of clinical experience, but experiences and observations should be recorded systematically and evaluated for biases and be replicable in other settings; (2) studying pathophysiology and disease are necessary but not sufficient to guides and predictions made without empirical evidence and understanding the rules of evidence is required to evaluate the literature concerning causes, prognoses, tests, and treatment strategies; and (4) regularly updating the literature and reading it keeps the process current (Evidence-Based Medicine Working Group, 1992).

So in evidence-based medicine there is less value given to authority, tradition, and expert opinion and more value placed on evidence. This is extremely important in assuring accurate and effective diagnostic and intervention techniques as well as in making sure that the profession of healthcare advances by testing existing methods and developing empirically-based new methodologies. Evidence-based practice is crucial for a number of situations where there are conflicting expert opinions on the diagnosis and treatment of a condition or where mistakes can be critical in the care of a patient.

For instance, the treatment protocols surrounding conditions such as cancer have been developed on the basis of RCTs with experimental and existing medications/interventions in order to ascertain the most effective approach to treating some serious conditions (Hoffmann et al., 2010). The increase in the effective treatment of many cancers is due to the reliance on evidence-based medicine. I agree that evidence-based is crucial for the continuing improvement of healthcare in general.