Tracy Bury - EBM: What it is and what it isn’t - 30DoS #30
In this final 30DoS for 2016, Director of Professional Policy at WCPT - Tracy Bury - writes about the seminal work of David Sackett and how it influenced her critical thinking.
The publication of Evidence based medicine: what it is and what it isn’t (Sackett et al) in 1996 was the culmination of a growing discourse on the challenges of integrating research evidence with clinical expertise for the benefit of patients. The authors also referenced EBM’s philosophical origins in mid-19th century Paris whilst describing it as a young discipline. The definition for EBM that was set out is now universally recognised. The importance of clinical experience, competency and judgement were applied to decision making in the face of the best available evidence and the individual patient context.
Whilst doing a Masters in Health Science in the early 1990s I was really interested in epidemiological research and medical ethics. These led me to the growing body of literature around the challenges of research generation and implementation. To me the work of Sackett and others made sense and was just as relevant to the practice of physiotherapists. It informed the direction my career has taken since with a focus on policy and advocacy, tools and resources, discussion and networking, that strives to make a difference, improving the lives of individuals and improving professional practice.
References
Eddy, DM. The Origins of Evidence-Based Medicine – A personal perspective. Am Med Ass J of Ethics 2011;13(1):55-60 http://journalofethics.ama-assn.org/2011/01/pdf/mhst1-1101.pdf
Rosenberg, W, Donald, A. Evidence based medicine: an approach to clinical problem-solving. BMJ 1995;310:1122 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2549505/pdf/bmj00590-0046.pdf
Sackett, DL, Rosenberg WMC, Gray, JAM, Haynes, RB, Richardson, WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71 http://www.bmj.com/content/312/7023/71
Zimerman, AL. Evidence-Based Medicine: Ashort history of a modern medical movement. Am Med Ass J of Ethics 2013;15(1):71-76 http://journalofethics.ama-assn.org/2013/01/pdf/mhst1-1301.pdf