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Delfini 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.
| 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 |
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| Safety |
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| Effectiveness |
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| Cost |
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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.
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