The pharmaceutical evidence based medicine makes reference to the process of analyzing, evaluating and using constantly clinical research results to provide optimal clinical patient care. It is important that patients know about evidence-based medicine in order to make informed decisions about the treatment and management of their disease. It also improves patient understanding of risk, encourages the use of elective procedures, and supports evidence-based decision making for physicians and patients.
Evidence-based medicine combines principles and methods
When applied, they ensure that policies, guidelines and medical decisions are based on the best current evidence on the effects of different forms of treatment and health care in general. When it comes to drugs, evidence-based medicine relies heavily on information from the assessment of benefits and risks (efficacy and safety).
The concept of evidence-based medicine emerged in the 1950s
Prior to that time, medical decisions were mostly based on medical education, clinical experience and reading literature. Studies have shown that treatment decisions differ significantly between healthcare professionals. It therefore seemed necessary to put in place systematic methods of collecting, evaluating and organizing research data, which led to evidence-based medicine. Since its inception, evidence-based medicine has gained recognition from physicians, pharmaceutical companies, regulatory authorities and the general public.
Before making a treatment decision, one should consider one’s own clinical experience and the best evidence from research and controlled studies. It is important to combine clinical experience and controlled studies for decision making. Without clinical experience, the risk associated with a given treatment can end up causing unwanted effects.
Five-step model of evidence-based medicine
- One of the approaches to evidence-based medicine is a 5- step model:
- Define the clinically relevant question (the doctor searches for information to find the correct diagnosis)
- Look for the best evidence (the doctor looks for evidence supporting the outcome of the first step)
- Assess the quality of the evidence (the doctor ensures the high quality and reliability)
- Act on the evidence to arrive at a clinical decision (based on steps 1 to 3, the patient and physician together make an informed treatment decision)
Evaluate the process (the doctor and the patient evaluate whether the desired result is obtained and, if so, modify the treatment decisions accordingly).
Returning to the example from the beginning, the physician’s decision corresponds to the principles of evidence-based medicine and the patient’s reactions. The physician’s decision includes the judicious, explicit and conscientious use of the best evidence at the present time, taking into account the patient’s experience, in order to decide on the best possible medical treatment for a given patient.
Patient participation in the decision-making process plays an important role in developing new recommendations for treatment principles. This includes reading and understanding health information, acting on it, cooperating with physicians to assess and select relevant treatment options, and commenting on the results. Patients have an active role to play at all levels in evidence-based medicine.
Evidence Assessment in Evidence-Based Medicine
To assess the quality of the evidence, the information collected is classified according to the different levels of evidence. The pyramid in the figure below illustrates the different levels of evidence and their relative ranking.
