gms | German Medical Science

Evidence based medicine (EBM) has been providing effective strategy for improvement of medical care for about a quarter century. While EBM originally focused on critical appraisal, development of systematic reviews and clinical practice guideline, today the main challenge for EBM is to provide support of decision making by relating decisions to other science disciplines [1]. Because evidence can determine decisions only in the context of values and preferences, both patient autonomy and health-related values accepted in the society call attention to the importance of shared decision making. Decision aids that communicate harms, benefits and alternatives in an easily understood manner not only to health care professionals but also to financing authorities and consumers may help in facing the considerable challenges of shared decision making. Still, limitations like restricted view of evidence, bias of the easily measurable and bias of commissioned research represent significant hurdles in both decision making and implementing the decision [2]. Data obtained at systematically reviewing 106 relevant articles discussing EBM [3] indicated that among the many barriers to the implementation and use of EBM lack of resources was the most consistent finding. It is to be emphasised that today EBM is not a fancy idea anymore but rather an actual working tool that – if properly fuelled and allowed to run – may contribute considerably to improving health care quality.