on evidence-based medicine—
for consumers & their clinicians

About the principles and processes we use when we analyze the medical literature to make recommendations for care choices. 

We use a process called Evidence-based Medicine (EBM) to tell you the best information we have about different medical choices.


Resources:
About EBM
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About Evidence-based Medicine
Evidence-based medicine (EBM) is a relatively new and improved way of using science to help doctors understand the best way to practice medicine. In medical publications, there are good research studies and not-so-good research studies. There are also instances where the studies are of high quality but the results are weak or contradictory. This can be confusing even to the best of doctors. EBM helps make science easier to understand for both doctors and patients.

In EBM, research studies are evaluated by experts to find the “best available” evidence. This helps doctors and patients more accurately predict the health benefits and health risks that patients might expect from using specific drugs or undergoing certain procedures.
About Medications

People react differently to the same medication – a medication that works well for someone else might not be the best choice for you. Often there is no way to know ahead of time which drug will work best for a specific person. Frequently, the best that science can tell us are the chances of known benefit or risk by examining health results in a group of people who may be similar to you or different from you in important ways.

This is similar to what happens in a lottery. Each person has so many chances to win or lose, based on estimates of the odds of winning or losing.
About Drug Families
Many drugs are so similar that they are considered to be in the same "family" or "drug class." Drugs in the same class are often substituted for each other even if research has not been done for each of the specific drugs. If one type of medication has not worked for you, there may be another drug in the same medication "family" or "drug class" which may work very well. Be aware, however, that drugs in the same family may differ in both their effectiveness and their side effects. You do not always have to change to a newer, more expensive drug to find a solution. However, sometimes a newer drug may be the best solution for you.
About New Drugs
Many of us become hopeful when we learn about a new drug on the market. But new does not always mean improved. We need good science, through evidence-based medicine, to learn if a new drug really is better – or even as good as – the older drug. And sometimes this takes time before we know.

Many patients begin treatment with lifestyle changes and older drugs that are frequently “over-the-counter.” Many of these patients do well without ever needing the newer and usually more expensive medications.

There are some definite advantages to taking this more conservative approach:
Advantages of a Conservative Approach to Drug Use

Safety

  • Older medications may be safer.
  • Newer medications are sometimes found after a year or more to have unsuspected side effects or health risks.
  • Most long-term risks of newly-approved medications are not known until physicians discover unsuspected side effects in their patients over time. (For example, it took several years before it was discovered that certain drugs used by millions of people to treat heart attacks actually increased heart problems.)

Effectiveness

  • Many newer medications provide little improvement for patients.
  • Even when effective advertising and marketing make it appear that the newer medications are “breakthroughs,” often they are not.

Cost

  • Cost is a real issue.
  • Older drugs are frequently less expensive than newer medications.

However, many new drugs are significant advances in health care. You need to make a decision based on what you feel may be most right for you.
Further Reading about Evidence based Practice

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Delfini SERVICES
We offer a wide range of supportive services with the ultimate goal of increasing health care organizations’ and clinicians’ abilities to provide high quality, evidence-based care and to improve medical decision-making for organizations, leaders, teams, clinicians and patients.

 

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