The need for evidence-based, non-drug medicine
-
Søren Ventegodt
,
Gary Orr
Abstract
Evidence-based medicine (EBM) is defined as “the integration of best research evidence with clinical expertise and patient values.” EBM is based on three equally important key factors: i) the best available scientific evidence; ii) the physician’s experience and intuition; and, iii) the preferences and values of the patient. EBM uses a hierarchy of evidence and critical appraisal of the sources, which makes it possible to balance high quality evidence with documented effectiveness. A treatment that is more safe and effective, but less well documented may very well be the treatment of choice. Ethics (not putting the patient at risk of harm with a treatment if this can be avoided at all) is an important part of EBM. Many pharmaceutical drugs have a number needed to treat (NNT) of approximately 20 [NNT=20, confidence interval CI (5–50)] and the number needed to harm is less well understood and documented. The adverse effect profile of pharmacological agents can be more harmful than non-drug medicine. Most EBM-treatments are likely to be non-drug treatments in the future. There are six steps to the practice of EBM: i) the patients and the physician must work together to define the problem; ii) the patients and the physician must explore the patient’s values and preferences; iii) the information about the possible alternative medical interventions must be discussed and critically appraised; iv) the best, relevant evidence must be applied to the patient as a treatment or cure; v) together, the patient and the physician must evaluate how useful the intervention was; and vi) if the intervention did not help sufficiently, the process must begin again. In this review, we explain, in our opinion, how non-drug EBM should be practiced.
©2012 by Walter de Gruyter Berlin Boston
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- Masthead
- Masthead
- Editorial
- Dean Ornish should receive the Nobel prize in medicine
- Review Articles
- Adolescent suicide in New York City: plenty of room for new research
- Consequences of prenatal substance use
- The need for evidence-based, non-drug medicine
- Teaching medical professionals and trainees about adolescent suicide prevention: five key problems
- Original Articles
- Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda
- Educational impact of peer-intervention on the knowledge and attitudes about HIV/AIDS in adolescents in Panama
- Tobacco brand preference among Mexican adolescents
- Spirituality and substance use in a sample of Russian adolescents
- Collaborative evaluation and management of students’ health-related physical fitness: applications of cluster analysis and the classification tree
- Body weight satisfaction among New Zealand adolescents: findings from a national survey
- Prevalence of common mental disorders among Dutch medical students and related use and need of mental health care: a cross-sectional study
- Reaching Jewish ultra-orthodox adolescents: results from a targeted smoking prevention trial
- Case Report
- Rare cases of disorders of sex development (DSD) in adolescents with female phenotype
