Evidence-based medicine — panacea or profanity?


Increasingly, both in the professional environment of physicians and in everyday life, the term “evidence-based medicine” (eng. “evidence-based medicine”) is used.

The connotations are very different –

  • from obsequious worship and rigorous acceptance
  • to categorical rejection and the most severe criticism.

In this publication, I will try to describe the key provisions, pros and cons, and my personal understanding of the applied meaning of this concept.

Синонимичными терминами являются “научная медицина”, “надлежащая клиническая практика“, даже “клиническая эпидемиология”, и т.п.

Synonymous terms are “scientific medicine”, “good clinical practice”, even “clinical epidemiology”, etc.

To determine what exactly can be considered evidence-based in medicine, developed and continue to develop:

  • methodology for conducting scientific medical research,
  • classification of various sources of research with the allocation of the so-called levels (groups) of evidence,
  • registers,
  • expert groups,
  • standards and clinical guidelines
  • and much more, which allows everyone involved in medical activities to carry it out in the best possible way.

It seems to be a solid positive. Where is the criticism?

From what I know, the main criticism of evidence-based medicine comes down to the following:

  • conflicts of interest – for example, pharmaceutical companies are interested in funding certain studies that are beneficial to them (and there is a temptation to hide negative aspects, or even influence their results);
  • too strong generalization or, conversely, excessive selectivity – for example, it is rarely possible to take into account the individual characteristics of a particular patient, combinations of diseases, etc.;
  • the complexity of obtaining evidence-based data, and hence the impossibility in the foreseeable future to conduct scientific research of the highest level of evidence even on the most pressing problems of medicine, especially on all;
  • fraudulent use of this concept solely for marketing purposes and so on.

All this is true in whole or in part.

Although none of the specialists, being in their right mind, denies that so far we have nothing better than the provisions of evidence-based medicine.

And we owe many of the achievements of modern medicine precisely to the evidence-based, scientific approach.

Ideally, the most reasonable (evidence-based, appropriate) medical practice is considered to be one that takes into account at least three aspects:

  1. medical datawith the highest level of evidence;
  2. clinical thinkingand medical experience;
  3. individual characteristics and patient satisfaction.

Because our projects

Research Institute of Evidence-Based Medicine and

Association of Evidence-Based Medicine

and given just such names.

And in the network of our own medical offices, centers, clinics “My Doctor“, which is part of the Research Institute of Evidence-Based Medicine, the principle of evidence-based medicine “with a soul”is chosen as a key concept.

We will consider various aspects of the problem of evidence in medicine in more detail in our future publications.

What do you think about this?

State your opinion and ask your questions in the comments, please.


Sincerely, Your Oleksii Kalmykov

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