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Evidence-Based Medicine: Adjusting to a Culture Shift in Health Care

by Bradley F. Marple, MD •

In point of fact, EBM has responded and evolved substantially since that time, as it has become more practical in its integration with traditional medicine. The emphasis now focuses on integrated decision making by the clinician. Perhaps this is best stated by one of the pioneers of EBM, Brian Haynes, MD, PhD:

As we continue our journey through the era of research-informed health care, the benefits that our patients will receive will depend increasingly on making care decisions that incorporate the clinical state and circumstances of each patient, their preferences and actions, and the best current evidence from research that pertains to the patient’s problem. The nature and scope of clinical expertise must expand to balance and integrate these factors.15

So, rather than a culture shift, it appears that the emergence of EBM marks an evolutionary step in the methodological approach to information processing. Increasingly available high-grade evidence provides sound information that can play a role in clinical decision making, but is not intended to replace physician experience and other forms of information. Indeed, in the era of research-enhanced health care, it remains prudent to still consider all information that is available.

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