[The role of epidemiological evidence in providing care for individual patients].
VU Medisch Centrum, afd. Inwendige Geneeskunde, Amsterdam, The Netherlands.Nederlands tijdschrift voor geneeskunde 01/2010; 154:A1910.
Evidence-based medicine is increasingly being viewed as a sine-qua-non for the modern and high-quality practice of medicine. 'Evidence' refers to the availability of epidemiological research. In this paper, we discuss a number of limitations of over-emphasis on epidemiological evidence. We focus on the availability, reliability and applicability of epidemiological evidence in the context of individualised medicine. We conclude that relying excessively on epidemiological evidence is a danger that we are insufficiently aware of. The implications of our conclusions for patient care and health policy are discussed. We propose that epidemiological evidence should be used for benchmarking average care provided by doctors working alone or in group practices, but not for benchmarking care provided to individual patients.
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ABSTRACT: This article describes evidence-based practice (EBP) in the health professions and sciences in general and in the rehabilitation disciplines specifically. It discusses the following: what counts as evidence and how that has changed over the last 4 decades, trends in the short history of evidence-based medicine and EBP, the fallacious nature of most criticisms of EBP, (perceived) shortcomings of clinical research and the resulting evidence in rehabilitation, resources available to clinicians who want their practice to be evidence-based, and the barriers these clinicians face in keeping up with the evidence and applying it in practice. Lastly, it describes how the development of a new art and science, knowledge translation, may play a role in truly making EBP feasible in rehabilitation services.Archives of physical medicine and rehabilitation 06/2012; 93(8 Suppl):S164-76. DOI:10.1016/j.apmr.2011.12.014 · 2.57 Impact Factor
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