The hard art of soft science: Evidence‐Based Medicine, Reasoned Medicine or both?

Abstract

In the past 14 years, Evidence-Based Medicine (EBM) has enjoyed unprecedented developments and gained widespread acceptance among health professionals. However, should we be content with producing, critically appraising and using the best evidence available for our understanding of health problems and decision making about them? Are our convictions about EBM's relevance, our conviction and intellectual satisfaction with its mastery and adoption enough? Should we continue pushing forward along this promising path, or should we further diversify the content and scope of EBM? Is EBM the only way to view medicine in the near future? This paper presents some options to choose from in terms of direction and content as well as questions to answer given the current EBM crossroads. More intensive and extensive EBM combined with 'other features'-based medicines may be the preferred strategy to follow in the future to determine the development, use and evaluation of EBM. Argument-based medicine or Reasoned Medicine is one of the options that can be integrated into the mainstream of medical reasoning and decision making.

Contemporary global perspectives of medical students on research during undergraduate medical education: a systematic literature review

“…Medical students who engage in research learn how to formulate cogent thoughts from the generation of research ideas through study implementation to dissemination. Furthermore, they would have applied the scientific process in what they did, what they found, and how to report and explain such findings with rigorous detail and accuracy [3,7]. Such early immersions can contribute to the development of lasting habits of scientific thought and profound dispositions toward critical thinking [2,3], a vital aptitude that enhances success in the practice of medicine and engenders a crucial mentality that deserves early nurturing [1–3].…”

“…Indeed, clinician literacy in research improves critical thinking in guiding clinical judgement – necessary ingredients for the effective application of evidence-based medicine [7]. The ability to competently locate and critically appraise the appropriate medical literature, interpret volumes of data, integrate, and translate those for use in clinical situations is invaluable to medical practice [7,8].…”

“…The ability to competently locate and critically appraise the appropriate medical literature, interpret volumes of data, integrate, and translate those for use in clinical situations is invaluable to medical practice [7,8]. The marriage between the clinical competence of a physician and the independent literature-based clinical evidence for informed decision-making could spell the difference between life and death of patients under potentially time-dependent conditions [7,9]. Such skills underscore the importance of the acquisition of research competencies and its crossover to the practice of evidence-based medicine [1–3].…”

Learning outcomes from a biomedical research course for second year osteopathic medical students

“…Research, EBM and statistics are of necessity interrelated, and to meaningfully navigate the medical research literature, practicing physicians may benefit from an applied, conceptual grasp of research concepts more than from a quantitative statistical rubric [3,4]. In fact, EBM experts endorse research literacy to improve critical thinking and enhance clinical decision making [5]. Thus we suggest that medical students may benefit in many important ways from acquiring biomedical research competencies early in their medical education.…”

Psychosocial interventions for people with diabetes and co-morbid depression. A systematic review

“…What is promising, however, is that eight of these ten studies were conducted in the last five years and two more ongoing studies were also identified, highlighting the research priority of this problem area. Ultimately, health professionals need to draw on their own experiences when managing people living with diabetes and co-morbid depression, and take into account their individual characteristics and preferences before making an informed decision regarding treatment options (Jenicek, 2006) as there is no panacea for the management of diabetes and co-morbid depression.…”