Up-to-date and evidence-based medicine, as we commonly know it, has been an interesting story so far. Although we now see it as a standard where quality care should be provided to patients, twenty years ago it was a controversial issue.
Evidence-based medicine really began to gain momentum in the late 19th century thanks to a small group of French clinicians. The French physician Claude Bernard was one of the first to begin to question the clinical efficacy of the customary practice of circulating blood for patients with pneumonia. Bernard helped introduce the idea that comparative trials and experiments could have a positive effect on clinical practice. At the time, there was a vigorous protest against this idea by most physicians who believed that medicine was a kind of art based solely on the intuition and experience of a physician. Popular physicians of his time believed that there was no tangible value in comparative experiments and statistics.
From then on the idea progressed dramatically. Experiences during World War I and II have led many nurses and physicians to look for ways to increase patient safety. Technological advances in sanitation, anesthesia, etc. have helped spur tremendous advances and innovations in technology and communications have helped convey these new findings to a global audience that has now found it easier to share current trials and trials.
In the following decades of the 80s, 90s and 2000s the computer, the internet and the ability to store and sort huge amounts of data grew rapidly and reliably in a way that was not possible before. By the mid-2000s most major peer-reviewed newspapers had online content and were easily accessible.
Despite all the progress, the idea of evidence-based medicine still faced considerable opposition. In the late mid-1990s, American physicians warned that evidence-based methods would create cooking-style medicine and physicians who did not tailor the treatment to the patient. They also warned that the movement itself is an arrogant attempt to lower costs and make more money through health services.
It is worth mentioning that the great availability and access to information can be a double-edged sword – there is a risk of disseminating incorrect information widely. A recent example of this can be found in the false clinical trials that took place in England regarding the links between vaccines and autism in the 1990s. A study has been published claiming an association between autism and the MMR vaccine. Although the study was found to be very suspenseful and bizarre, the information spread rapidly around the world and served as a crucial part of the evidence movement against vaccines.
We currently define evidence-based medicine as the ability to combine an individual clinical experience and the best external evidence. The ultimate goal is to improve patient care and patient safety in the organization. The term “best external evidence” refers to studies, trials, trials, and patient-centered data reviews that apply to the specific topic. Both doctors and nurses now feel comfortable with the idea that patient care should be centered around the best evidence in order to make the most appropriate decisions. In order to help “encourage motivation” for doctors as well as nurses, it is necessary to teach the required hours of training (CE) in each professional licensing cycle. Most training providers seek to create and provide material that focuses on evidence-based material for a specific topic. As we progress, healthcare providers must avoid complacency – continuous measurements and observing current practices will be the only way we can continue to advance medical and nursing practices and improve patient care levels in our organizations.