The integration of evidence based medicine and personal care in family practice

Knowledge and attitudes of physicians towards evidence based medicine in ilam, iran

BACKGROUND

Evidence based medicine (EBM) is very important in the process of decision making, diagnosis and treatment of patients. For years, medical schools have developed instructions for EBM to determine the attitude and knowledge of physicians towards EBM and their related educational needs.

MATERIALS AND METHODS

This study was a questionnaire study among physicians. One hundred twenty physicians were selected using stratified random sampling in Ilam. A main outcome measure was attitudes and knowledge of physicians toward EBM, ability to access and interpret evidence, and best method of moving from opinion based to EBM.

RESULTS

Of the 120 questionnaires we have sent, 94 (78.3%) were answered. 56.6% were using the internet to answer their patients questions and 23.8% used the internet to obtain clinical evidence. Mean and standard deviation (SD) of knowledge and attitude scores were 24% ± 23% and 72% ± 10%, respectively. Pearson correlation shows a significant relation between knowledge of physicians and years of graduation (r = -0.37, P = 0.00). There was a significant difference between mean of knowledge score of general practitioners, specialist and subspecialist (P = 0.026).

CONCLUSIONS

Knowledge and attitude of young physicians were more based on EBM compare to old physicians. A significant difference in knowledge mean score of physician shows that the EBM is still new in Iran, the future physician's critical need to learn EBM and necessity of entering EMB at all medical levels.

A critical appraisal of 'evidence-based medicine' in allergy and asthma

Clinical guidelines are 'systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances'. They may offer concise instructions on which diagnostic or screening tests to order, stipulate how medical services should be provided, how long patients should stay in hospital, or many other details relevant to clinical practice. This paper argues that guidelines should be simple, adapted to the clinical setting they inform and to treatment availability in their respective geographic context and that they should not be viewed as a yardstick but as support for physicians. The benefits of evidence-based-medicine (EBM), which defines the value of medical interventions in terms of empiric evidence from clinical trials, are growing in many contexts and are well described. Not sufficiently acknowledged, however, are the limits of EBM. A gap still exists between clinical research and clinical practice which should be better recognized and assessed.