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Making Informed Decisions for Better Health

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Evidence-based Medicine (EBM): Foundation for Best Practices

Medical knowledge is accumulating—and changing—with such dizzying speed that doctors, nurses, physician assistants, and other healthcare professionals have found they need new methods to cope with this abundance of information. Novel tests, drugs, procedures, and treatments are ever in development, put through clinical trials, and introduced to market. Studies are frequently published with fresh data that support or modify long-standing beliefs and sometimes lead to substantial changes in the care you receive.

Evidence-based medicine (EBM) is a formalized approach for helping healthcare practitioners harness the knowledge that comes with this information explosion and apply it to their daily practice. EBM helps to determine what scientific data support the best health outcomes. This leads to development of practice guidelines aimed at delivering on the promise of improved outcomes in the greatest number of cases. In laboratory medicine, EBM provides guidance that enables healthcare practitioners to optimize the selection of tests for screening for, diagnosing, and managing a variety of medical conditions.

Since evidence-based medicine primarily relies on research that measures health outcomes for a given population, it is somewhat at odds with individualized or personalized care. EBM-derived best practices are by their nature standardized to apply to as many people as possible. Complicated analyses of how a specific test affects the health outcomes of a given population allow scientists to develop guidelines that establish standards of practice that are most likely to result in favorable outcomes for the vast majority of the general population. Unfortunately, these guidelines aren't always able to take into account circumstances that are specific to the patient. That is why the skill and experience of the practitioner are needed in interpreting the guidelines, and why it is important for you as the patient to understand and be engaged in your care.

More recently, medical professionals have recognized that patient considerations impact outcomes. As a result, in some sectors of healthcare, there is increasing emphasis on including patient preferences, needs, and values [See "When Strong Evidence Agrees With Patient Preferences"] as part of the standard of care.

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