Abstract
The growing array of diagnostic and therapeutic options available to the clinician has created the necessity of techniques, such as the randomized clinical trial, to evaluate their effectiveness. Recently, with the increasing penetration of the methods of clinical epidemiology into medical practice, the concept of an evidence-based medicine has arisen. Emphasizing the necessity of solid clinical evidence for clinical decision-making, evidence-based medicine provides a framework for the integration of research results into clinical practice. The evidence is graded, principally on the basis of study design, and norms are established as to what constitutes adequate evidence for clinical decision-making. The combination of this new paradigm of medical practice with the power of modern telecommunications is causing a revolution in the way medicine is practiced. Its integration into clinical practice is being facilitated by quantitative overviews of the literature, and the creation of clinical guidelines based on these reviews. Shortcomings of the traditional sources of evidence have been documented. New sources of evidence, such as the ACP Journal Club, and the Cochrane Collaboration, diminish dramatically the time required of clinicians to obtain the best available evidence. All health professionals should familiarize themselves with evidence-based medicine.
Highlights
The growing array of diagnostic and therapeutic options available to the clinician has created the necessity of techniques, such as the randomized clinical trial, to evaluate their effectiveness
Emphasizing the necessity of solid clinical evidence for clinical decision-making, evidence-based medicine provides a framework for the integration of research results into clinical practice
The evidence is graded, principally on the basis of study design, and norms are established as to what constitutes adequate evidence for clinical decision-making. The combination of this new paradigm of medical practice with the power of modern telecommunications is causing a revolution in the way medicine is practiced
Summary
Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS. Ao enfatizar a necessidade de evidências clínico-epidemiológicas sólidas para as decisões clínicas, a medicina embasada em evidências forma a estrutura para a integração dos resultados de pesquisas na prática clínica. O resultado desses avanços está propiciando a construção de um novo paradigma para a medicina — uma medicina embasada em evidências[5,6], no qual, entre outras características, o médico:. — reconhece que a experiência clínica e os conhecimentos sobre mecanismos (de doenças, de intervenções), apesar de necessários no raciocínio clínico, são insuficientes para reduzir “satisfatoriamente” as incertezas de algumas decisões clínicas;. — aplica essas evidências à luz dos conhecimentos sobre mecanismos, das experiências clínicas pessoais e dos valores atribuídos pelos pacientes para tomar a melhor decisão clínica
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