Epidemiology, Evidenced-Based Medicine, and Evidence-Based Public Health

Abstract

Evidence-Based Medicine (EBM) is heralded as a new paradigm of medicine. Is it? What is its link to epidemiology? Does an evidence-based (EB) approach apply also to other health sciences and to public health in particular? What has epidemiology already achieved in these domains, and what remains to be done? What should our priorities be in the coming years? The EB approach is essential in all health sciences at two levels: for problem solving, and for decision making. It applies to all health sciences, be it medicine, nursing, public health, or others. Many epidemiological principles, methods and techniques are put into good use in EBM. The EB "movement" is attractive in it's use of clearly defined procedures, generalizing (not always explicitly) the application of good epidemiologic principles, methods, and techniques. Epidemiology must now contribute to the evaluation of the practice of an EB approach. If one does not have access to a good medical library nor information technology does the EBM paradigm still hold? Hence, clinical and public health guidelines will benefit first from the EBM approach, then daily practice of EBM will follow, conditions permitting. In public health, the challenges of the EB practice are not equally spread across health protection, different levels of disease prevention, and health promotion. The latter represents the most challenging task for epidemiology at any step of EB approach. Epidemiology, if successful in this domain, may help to build an EB health promotion. An Evidence-Based Public Health paradigm may be considered.

Priorización de enfermedades virales zoonóticas en la interfaz de cerdos silvestres, cerdos domésticos y seres humanos

“…Debido a la escasez de los datos disponibles, es necesario aplicar un enfoque que recurra a la opinión de expertos para obtener resultados consensuados que obtengan el respaldo de las partes interesadas en la priorización (89)(90)(91). Por ello, el presente estudio se debe continuar con la confrontación de los resultados obtenidos y con la búsqueda del consenso de los expertos.…”

Evidence Based Public Health Practice: A Fundamental Concept

“…In 1997, Jenicek defined EBPH as the "conscientious, explicit, and judicious use of current best evidence in making decisions about the care of communities and populations in the domain of health protection, disease prevention, health maintenance and improvement (health promotion)". 5 In 1999, scholars and practitioners in Australia and the United States elaborated further on the concept of EBPH. Glasziou and colleagues posed a series of questions to enhance uptake of EBPH (e.g., "Does this intervention help alleviate this problem?")…”

Sobre la salud pública basada en pruebas

“…LA SALUD PÚBLICA BASADA EN PRUEBAS En este contexto se propone el concepto de "Salud Pública Basada en la Evidencia"(SPBE), entendida por Jenicek como "el uso consciente, explícito y juicioso de la mejor evidencia en la toma de decisiones sobre la atención a comunidades y poblaciones en el campo de la protección de la salud, la prevención de la enfermedad y el mantenimiento y mejora de la salud" 11 . Esta descripción subraya la necesidad de basar la toma de decisiones en salud públi-ca en la mejor evidencia científica disponible e implica un proceso previo de recopilación y evaluación crítica de la literatura.…”