Why Is EBM Important? (2 of 2)

• The WHI study was superior to all the previous studies for a number of reasons but mainly because it was conducted prospectively, and was a double-blind, placebo-controlled study. The previous studies were all retrospective cohort studies and not as high a level of evidence as the WHI.
• Two more good examples from JAMA 1992; 268:240:
  • Thrombolytic drugs for acute MI: first systematic review (SR) of randomized, controlled trials demonstrated reduced mortality six years before most review articles and textbooks (expert opinion) recommended their use.
  • Aspirin after acute MI: not recommended by expert opinion until 6 years after first SR
• Clearly physicians need the skills to monitor the literature to be able to put new medical knowledge into practice in a timely and efficient manner.

So how does the average physician cope with this ever increasing amount of new medical information, especially in light of the increasing demands on their time?

• The answer to this question in large part is that physicians must learn a methodology to efficiently sift through the medical literature to find answers to their clinical questions as they arise in practice.
  
• We call this the EBM process.