Trish Greenhalgh - ‘Real v Rubbish EBM’

[@dionkobussen1622]

Thanks prof. Greenhalgh!

[@anoopmahadevan5889]

Summary Trish Greenhalgh critiques evidence-based medicine (EBM), emphasizing the need for individualization in patient care rather than rigid adherence to guidelines. Highlights 🩺 Individualization: EBM should focus on individual patient circumstances rather than just population data. 📚 Historical Context: The lack of individualization has been a critical issue in EBM for over 20 years. 🔍 Clinical Judgment: Integrating clinical judgment with evidence is essential for effective patient management. ⚖️ Patient Perspective: Understanding the patient’s narrative and context is crucial for appropriate treatment. 🗂️ Guidelines Limitations: Rigid guidelines can lead to mismanagement if they overlook unique patient details. ⚠️ Interpreting Evidence: Evidence must be interpreted in the context of the individual patient rather than applied universally. 🔄 Evolving Practice: There is a need to return to traditional clinical methods alongside EBM to better address patient needs. Key Insights 🌐 Evolving EBM: EBM should evolve to prioritize individual patient needs over broad epidemiological data, ensuring personalized care. This shift can enhance patient outcomes and satisfaction. 🧠 Integration of Knowledge: Effective clinical practice requires a blend of evidence, clinical judgment, and patient insights, creating a holistic approach to healthcare. This integration fosters better decision-making. 📖 Patient Narratives: Listening to a patient’s story is critical; it provides context that guidelines may miss. Understanding their history and circumstances can lead to more tailored and effective treatments. 🔄 Questioning Guidelines: Clinicians must not blindly follow guidelines but assess their applicability to each patient, recognizing that clinical situations are often more complex than guidelines suggest. ⚖️ Ethical Decision-Making: Decisions about patient care must involve ethical considerations and multidisciplinary deliberation, ensuring that the patient’s best interests are prioritized. 🏥 Real-World Application: Using real clinical cases in training can enhance the understanding of EBM, helping future healthcare professionals navigate the complexities of patient care effectively. 🔍 Critical Analysis of Evidence: A critical perspective on existing evidence is necessary; not all research is applicable to every patient, and recognizing this is vital for sound clinical practice. Summary

[@mamineh3597]

Outstanding

[@tenorrecorderblockflutestu524]

Yes, but this is what we studied in 80s. Gestalt, totality of perception of physician about the patient. I don;t know how this approach will help to curb overdiagnosis and overtreatment which plagues modern western medicine and creates long waiting lists.