Have you read about medical acupuncture? if not, I suggest you read it first because it related to our discussion this time: Evidence-Based Medicine or popularly called EBM.
EBM (Evidence-based Medicine) is the new paradigm in medical science. EBM states that medical practice must be based on the latest and most trusted scientific evidence.
It means those evidence must be accountable, both scientifically, medically, clinically, and also statistically significant.
Therefore, in practice, EBM combines the clinical capabilities and experience with the most reliable and latest scientific evidence.
As a result, the main requirement to facilitate the evidence-based clinical decision making is to provide the scientific evidence that is relevant to the prioritized clinical problem at hand, which come in form of meta-analysis, systematic review, and randomized double-blind controlled clinical trial (RCT).
Why EBM ?
In short words, there are a few main reasons why we need EBM:
1. In everyday practice we need always updated information about diagnosis, prognosis, therapy, and prevention, promotion and rehabilitation That’s because diagnostic and therapeutic technology is always evolving
2. Traditional information (e.g. those can be found in the textbook) is very inadequate now. Some of it is even flawed and misleading (for example, the information from drug manufacturers submitted by pharmaceutical / detailer ambassador), and it is also not ineffective or it could be too many, which mostly confusing (for example, biomedical/medical magazine (journals)).
3. With the increase in a person’s clinical experience, the ability/skill to diagnose and establish the form of therapy (clinical judgment) also increases. But, at the same time, the scientific ability (caused by the limitation of accessible information) and clinical performance (caused by using only their experience, which mostly isn’t scientifically accountable) decrease significantly. Moreover, with the increase in patient numbers, the time needed to provide the service will become much longer. It makes the time that can be used to update the knowledge (for example, by reading medical journals) is decreasing.
The Important Component of EBM
In more detailed explanation, EBM is the integration between:
1. Best research evidence
It means that that scientific evidence must come from the studies conducted with the very trusted and correct methodology (especially the randomized double-blind controlled clinical trial). The studies mentioned here must also use the research variables that can be measured and assessed objectively (such as blood pressure, Hb levels, and cholesterol levels) In addition, it also utilizes the measuring methods that can avoid the risk of “bias” from the author or researcher.
2. Clinical expertise
In order to describe EBM, we need an adequate skill. It is including the skill to identify the patient’s condition and determine the diagnosis correctly and quickly, including identifying the risk factors and predict the risk and benefits from any intervention that will be given. This clinical skill must be accompanied by the good understanding of values that patients believe. As well as implied expectation from the patient.
3. Patient values
Every patient, from any origin, tribe or religion, certainly has something unique about their health and illness status. The patient also has hope for recovery from the medication and treatment they received. A clinician or medical practitioner must understand this matter. So every health service they are given to the patient, besides it can be accepted and based on the scientific evidence, it must also consider the subjective value from the patient.
Given that EBM is a scientific approach used for therapy decision making, the scientific bases of a study need to be tested its reliability in order to acquire the updated result, which also can be used as the base for decision making.
EBM and Medical Acupuncture
EBM is the most important element in the principal of the medical acupuncture. Especially for the acupuncturist who works in a hospital or clinic which will be working together with a doctor or other medical field specialist. Therefore, all kinds of decision and acts of acupuncture practice must be based on scientific evidence. Likewise with the recording in the medical record.
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