Evidence Based Medecine, do we know how to use it?

Health Education Center in Blantyre, Malawi

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As an avid twitter user, I do find frequently, very interesting post related to subjects that I cherish. A few days ago an interesting article was brought to my attention :  http://www.biomedcentral.com/content/pdf/1741-7015-9-30.pdf

The authors reason for this study was : ” Background: Independent evaluation of clinical evidence is advocated in evidence-based medicine (EBM). However, authors’ conclusions are often appealing for readers who look for quick messages. We assessed how well a group of Malaysian hospital practitioners and medical students derived their own conclusions from systematic reviews (SRs) and to what extent these were influenced by their prior beliefs and the direction of the study results.”

Systematics reviews, metaanalysis, are often only checked for their conclusions. But do we actually read and comprehend those conclusions?

The author’s  “Conclusions: The majority of our participants could not generate appropriate conclusions from SRs

independently. Judicious direction from the authors’ conclusions still appears crucial to guiding our

health care practitioners in identifying appropriate messages from research. Authors, editors and

reviewers should ensure that the conclusions of a paper accurately reflect the results.”

As practitioners we should incorporate suitable clinical evidence into our daily clinical decision making. But it is really hard to make those decisions, when we know that so many publications are tainted by a bias . The bias can be of different origins, a positive result is easily  published, while a negative one will not find an easy way to be published. The industry drives so many studies, that it is difficult to be sure of what the real results are.

Going back to the article that I recommend today, some of their findings are : “After reading the SRs, fewer than one-half (47.0%) of participants who had the inappropriate belief changed their beliefs and chose the appropriate direction of effects.”

Our previous beliefs, could be more important in a decision making situation, how strange, we are humans and very often with strong beliefs.

Author’s said : “Our results suggest that the majority of our participants could not interpret research findings accurately in the absence of guidance provided by the authors’ conclusions, and positive SRs appeared to have greater influence than negative SRs in directing the readers’ postreading conclusions”

It is everybody ready to interpret and follow systematic reviews? and are we ready to find our own conclusions from what we read.

In my speciality field, so many colleagues still practice based on opinions, more than in any kind of serious study.

Even if a small but growing group of health professionals try everyday to bring “good” science to the clinical side, it is not an easy road.

Un saludo caminante

Acerca de flyerlpa

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