Evidence-based Medicine Not Well Incorporated into Clinical Practice

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Highlights:

• American doctors appear to adopt evidence-based medicine in their clinical practice only around 50% of the time
• The delay in adopting evidence-based medicine can be attributed to patient demands and difficulty in giving up older treatments
• Since patients trust their doctors the most when it comes to health care, doctors could play an important role in introducing evidence-based practices in their patients

A recent article written in the Vox by Eric M. Patashnik, the Julis-Rabinowitz professor of public policy and a professor of political science at Brown University, and co-author of Unhealthy Politics: The Battle over Evidence-Based Medicine explains the reluctance of the American doctors in wholeheartedly adopting evidence-based medicine into their clinical practice, some points from which are highlighted below:

Evidence-based medicine refers to medical practices that undergo rigorous assessments in clinical trials and other research methodologies so that their effectiveness as well as safety can be established. The adoption of practices based on evidence offers the best treatment options for patients.

‘American doctors do not appear to be completely open to adopting evidence-based medicine into clinical practice.’

During the reassessment of practices that are already approved and in clinical practice, it is sometimes found that these practices are not associated with the same benefits that they were expected to cause when they were first approved. For example:

• A study published in the New England Journal of Medicine way back in 2002 demonstrated that an orthopedic procedure called arthroscopic debridement and lavage does not help in relieving pain and improving function in patients with osteoarthritis. Similar evidences of lack of benefit were noted for the orthopedic procedures spinal fusion and subacromial decompression.
• A recent study published in the Lancet indicated that stent placement in an artery of the heart to keep it patent when done for non-emergency cases does not produce significant benefit and relief of pain when compared to a sham surgery where the stent was not used. Thus, the benefit appears to be more likely due to a placebo effect of the procedure rather than the stent itself.

(https:www.vox.com/the-big-idea/2017/12/28/16823266/medical-treatments-evidence-based-expensive-cost-stents)Source: Medindia

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