Currently, the application of the knowledge derived from the best evidence results in optimizing the care of patients by doctors and at the same time improves the standards of their health institutions. This is achieved by involving a series of disciplines such as clinical epidemiology, critical reading of medical research, health technology assessment, health administration and management.
Despite the fact that there are multiple classifications or hierarchical systems of scientific evidence in medicine, they all have in common that they are grouped into categories that reflect scientific rigor and quality, and thus provide a guide when interpreting and incorporating them into our intake scheme. making decision.
The levels of evidence range from the lowest to the highest, with the smallest clinical case and the highest or best being a systematic review of randomized studies.
For a better understanding of the concept of evidence-based medicine, it is necessary to know and apply the concept of critical reading of medical literature and to know how to use mega-search engines to search for published articles.The levels of evidence range from least to greatest, the case being less clinical trial and the largest or best a systematic review of randomized studies.
After being clear about the concept of seeking the best existing and published evidence, we must enter and understand the concept of the application of evidence-based medicine (EBM) to the patient. For them we have defined the concept as the ABC of EBM, figure.
Patient care concept (abc-mbe)
A = Patient, B = Physician, C = Best Research Results (MBE).
- Point A of the graph, the patient can self-medicate without seeking medical help; it is common but not the right thing to do and sometimes patients arrive complicated or very late for medical attention.
- Point B and C of the graph cannot act on their own if there are no patients who request or come for help.
- Point AB on the graph is observed when the patient goes to a pharmacy and the pharmacist prescribes; when you seek help from a shaman or healer, when a doctor prescribes based on his experience without taking into account the research or studies of adequate quality; These examples are common in many Latin American countries
- Point AC of the graph is observed when the patient decides to search with the help of technology which is the best treatment recommended by the best studies and demands this behavior, it is not frequent, but it is increasing. We mean that a knowledgeable patient with technological facilities and tools seeks more directed and explicit help with his doctor. Possibly generate a better understanding between the two.
- MBE point, is when a patient asks the doctor for help and he uses his experience and existing knowledge based on the best studies and informs the patient of those results and both decide to make the best decision. It requires an up-to-date doctor, knowledgeable in critical reading and the concept of evidence-based medicine.
In summary, evidence or evidence-based medicine is a tool or discipline that every health professional and especially the doctor must master. Their understanding goes beyond the health profession that one has, it is required to know of adequate reading of medical articles and of an exhaustive search of what has been published and with it to locate the existing level of evidence and this share it with the patient to take the best decision.
Dr. Paulino Vigil-De Gracia
