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 *The principles of evidence-based medicine were first codified by Dr. David Sackett, an English Internist, in the 1970's. Unfortunately, over time, the principles of evidence-based medicine (or "EBM") have been frequently and increasingly misinterpreted and misused, prompting Dr. Sackett and his colleagues to publish a clarification in the British Medical Journal in 1996 (Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn't. BMJ 1996;312:71-2.). Dr. Sackett explains: "Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research." The authors clarify what "real" EBM involves: "By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer." At BSPS, evidence-based medical principles are put into clinical spine practice precisely as supported by Dr. Sackett and his colleagues. |
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