Document Detail


The challenge of evidence in clinical medicine.
MedLine Citation:
PMID:  20367870     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The primary goal of evidence-based medicine (EBM) has been to change the way clinicians make decisions. But EBM has inappropriately privileged the results of clinical research for medical decision making and has undermined the importance of other kinds of medical knowledge, pathophysiologic understanding and clinical experience, to clinical practice. Here, the specific advantages and limitations of each kind of medical knowledge are examined. No particular kind of medical knowledge is necessarily more compelling than the others when it comes to making specific patient care decisions. Several cases where medical knowledge is conflicting are examined to demonstrate the weighting and negotiation necessary for sound clinical judgement. Expert clinicians must utilize a variety of reasons and methods of reasoning in arriving at the best clinical decision or recommendation for an individual patient. The process can be formalized and made explicit, but it cannot be narrowed, simplified and focused only on the results of clinical research.
Authors:
Mark R Tonelli
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  16     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  384-9     Citation Subset:  IM    
Affiliation:
University of Washington, Seattle, WA, USA. tonelli@u.washington.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Clinical Medicine*
Decision Making*
Evidence-Based Medicine*
Health Knowledge, Attitudes, Practice
Humans
Comments/Corrections
Comment In:
J Eval Clin Pract. 2010 Apr;16(2):390-1   [PMID:  20367871 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Prudent evidence-fettered shared decision making.
Next Document:  Narrative evidence and evidence-based medicine.