What is Evidence Based Medicine (EBM)?
It is an applied aspect of clinical epidemiology…??? What that means is that the practice of medicine should be based on valid, clinically relevant research data whenever possible.
The way I like to think of EBM, and why I think it is relevant to my veterinary practice, is that it is a tool to improve my medicine. There is a variety of information “out there” and we need to rank its usefulness. Basically, as Dr. McKenzie described it, EMB creates a pyramid of data with super-duper extensive reviews of all the data on the planet at the top…and what is affectionately known as “In My Experience” at the bottom.
Great! That Makes Everything Easier Right?
Nope!
Human medicine has oodles of data and studies and reviews of studies and compilations of reviews of studies available to sort through. Veterinary medicine has not so much.
Exotic veterinary medicine has way less.
Well, How Does EBM Help Then?
Data has to come from somewhere. It may well start with an “In My Experience” which turns into a case report or a case series. Then someone tries to get more information through a study (double blinded is the best!).
Eventually we’ll have enough studies to be able to summarize the data in a great big review.
But until then, EMB reminds us to critically evaluate where our information comes from, not to discard the lower levels but understand they are incomplete.
For more information, check out the Evidence Based Veterinary Medical Association.