What's the difference between evidence-based medicine and evidence-informed practice?
In our minds, the letter term is broader in several ways: A,
it includes other clinical practices besides medicine, and B,
it includes a variety of forms of evidence which
includes the best scientific research and more.
This video explores this difference, why it matters,
and how evidence-informed practice applies to integrative therapies.
The term evidence-based medicine or EBM arose in
the 1990s as a systemic approach to analyze published research.
It's the basis of clinical decision-making.
In 1996, the term was more formally defined by Sacket et al,
who stated that EBM was the conscientious and judicious use of
the current best evidence from
clinical care research in the management of individual patients.
The development of the internet allowed
incredible access to masses of data and research evidence,
but it overwhelmed clinicians.
To begin with, evidence-based medicine relied on one type of evidence,
published scientific research that may or may not be applicable to an individual patient.
Paper nor patients as you see in this photo.
It also focused on medicine to the exclusion of
other health care practitioners and other types of therapies.
Finally, it was not always practical with
the explosion of scientific knowledge being published,
it was difficult for clinicians to stay current on best practices.
In fact, for a primary care physician to stay up to date,
they'd need to read 17 articles a day,
365 days a year.
Evidence-informed practice means integrating the best available evidence from
the systemic research with
individual clinical expertise and the patient's needs and preferences.
We emphasize systemic research because
summary sources such as systematic reviews, meta-analysis,
and importantly, clinical guidelines provide
good quality evidence but take much less work for clinicians.
Summary sources find that all the relevant research studies that address
a particular question and assess the quality beat study,
including only the well-done studies in the compiled results.
By clinical expertise, we mean the proficiency and judgment that
individual clinicians acquire through clinical experience and clinical practice.
It involves the experience of the individual clinician,
but also the collective experience of a profession.
For example, Acupuncture and Oriental medicine draw from
the collective experience of thousands of practitioners gained over 2,000 years.
Patient presentation provides important information that can inform clinical decisions.
This varies from person to person and conclude on individual's culture, personal values,
previous experience with other health care providers and in other healthcare settings,
expectations and preferences, ability to pay for health care,
health history, symptoms, and physical signs.
While health history and physical presentation
is obviously needed to provide patient care,
a patient's previous experience,
values, expectations, and preferences can also have
a profound impact on patient choices and on treatment outcomes.
So, like evidence-based medicine,
evidence-informed practice is also informed by science and research,
but it is more person-centered.
It incorporates the patient, the clinics expertise,
and other resources such as health care professionals,
informational sources, material sources,
all to provide patient care.
