Evidence Based Medicine
Evidence based medicine is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. Evidence based medicne integrates clinical experience and patient values with the best available research information [1].
The Randomised Controlled Trial or RCT is considered the gold standard for medical evidence. The effectiveness of a treatment is tested by comparing patient groups who have been treated or have not been treated (the placebo group). Optionally, the effect is also compared to a third treatment method. Important is the completely random classification of the research groups. Doctors nor patents are aware who is in which group, this prevents that patients who are considered to be in "best" shape receiving the "best" treatment.
Good care depends on the situation and the patient; and sometimes you also have to dare to deliver unproven care. One of the biggest mistakes that we can make is to only believe in science to support a claim, because if we only believe in the things that science has already definitely proven, we are missing the entire point. In order to move forward we need to be theoretical, we need to define the things that cannot be defined and be satisfied with the things that probably may not be defined in our lifetimes. Sometimes we cannot conceptualise what certain things entail because of their magnitude. Inserting a little bit of doubt into any set system is something we must do in favour of progress. Allowing the possibility to use unproven care could potentially make a big positive impact.
- Scholten RPJM, Offringa M, Assendelft WJJ. Introduction in evidence-based medicine. Houten: Bohn Stafleu van Loghum, 2013.
