Document Detail


Evidence-based medicine: opportunities and challenges in a diverse society.
MedLine Citation:
PMID:  21959026     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In this article we explore the discourse and practice of evidence-based medicine (EBM) in the context of social and cultural diversity. The article consists of 2 parts. First, we begin by defining EBM, describing its historical development and current ascendance in medical practice. We then note its importance in contemporary psychiatry, comparing dynamics between the United States and Canada. Secondly, we offer a constructive critique of the application of EBM and evidence-based practices in the context of ethnocultural diversity, as one consistent reflection on the EBM literature is that it is does not adequately address issues of diversity. In doing so, we use the situation here in Canada as an extended case study, though our observations will likely be applicable in other diverse nations, such as the United States, the United Kingdom, and Australia. We critically examine the following 6 issues related to the practice of EBM in a diverse society: generalizability and transferability of evidence-based interventions; diversifying standards of evidence in EBM; strategies to address diversity in EBM research; cultural adaptations of evidence-based interventions; integrating idiographic knowledge; and, training and health service delivery. Concurrent with our critique, we offer research and practice suggestions that may address outstanding challenges vis-à-vis the practice of EBM in a diverse society. These include a need for more effectiveness research, more openness to diverse sources of knowledge, better integration of idiographic and nomothetic knowledge, and a critical approach to extrapolation and transfer of knowledge.
Authors:
Rob Whitley; Cecile Rousseau; Elizabeth Carpenter-Song; Laurence J Kirmayer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of psychiatry. Revue canadienne de psychiatrie     Volume:  56     ISSN:  1497-0015     ISO Abbreviation:  Can J Psychiatry     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7904187     Medline TA:  Can J Psychiatry     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  514-22     Citation Subset:  IM    
Affiliation:
Assistant Professor, Douglas Mental Health University Institute, Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec.
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