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EBM Provides Patients with Consistent, Effective Care

Image of Military personnel hosting a training program. Click to open a larger version of the image. The Defense Health Agency’s Continuing Education Program Office within the Education and Training Directorate is hosting a learning opportunity, “Exploring Evidence-Based Practice in Modern Medicine Primary Care,” June 24 from 7:45 a.m. – 4:15 p.m., as part of its Clinical Communities Speaker Series (Photo by: Jason W. Edwards, Brook Army Medical Center).

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Many of the physicians within the Defense Health Agency appreciate the value that evidence-based medicine brings to the patient experience, because it enables them to make thorough clinical decisions based on their patients' best interest. These decisions of care are based upon the most current information about the illness or injury and most viable treatment.

The Defense Health Agency's Continuing Education Program Office within the Education and Training Directorate is hosting a learning opportunity, "Exploring Evidence-Based Practice in Modern Medicine Primary Care," June 24 from 7:45 a.m. – 4:15 p.m., as part of its Clinical Communities Speaker Series.

The term "evidence-based medicine" (EBM) has spread through medicine with amazing speed during the past fifteen years. The adoption of EBM signifies the fundamental idea that what happens to patients should, to the greatest extent possible, be based on evidence.

Dr. James Giordano, a professor in the Departments of Neurology and Biochemistry at Georgetown University Medical Center, in Washington D.C., who will be the guest lecturer at this event, explained how EBM offers pragmatic results that can be used to validate outcomes or to clarify mechanisms, and in some cases both, to demonstrate utility of a technique or paradigm as relevant to a specific domain of medicine.

"The growing call for precision and personalized care, coupled to an understanding and appreciation of patients as bio-psychosocial beings mandates that research take individual, as well as community/cultural (physical, psychological, and social) factors, into accord," said Giordano, who also serves also as bioethicist with the Department of Defense's Medical Ethics Center.

Evidence appearing in the peer-reviewed biomedical literature is ranked according to the type and quality of studies employed to acquire the relevant experimental and/or clinical data. This enables clinicians to use evidence rankings as a metric to assess the relative value of certain interventions, as relevant to the clinical case at hand.

Army Col. (Dr.) Timothy Switaj, chief medical officer for the San Antonio Military Health System, is an advocate of evidence-based medicine and has practiced it for many years during his career.

"Evidence based medicine is a good guide that bridges clinical judgment, scientific evidence, and the patient's values and preferences, but it is not the end all be all of medicine," said Switaj, a family medicine physician with almost two decades of Army service. "Not every patient fits the mold or as we say 'reads the textbook'."

For physicians, it allows for effective evaluation of benefit/burden (risk ratio); enhances knowledge on all levels necessary for adequate practicality in resolving decision making when prescribing patient care.

Regarding patients, EBM allows adequate informational basis to consent to treatment, affords equity in disparity of vulnerability and finally allows for participation in resolution of care.

"EBM is grounded in moral obligation of maximizing good while upholding the fiduciary nature of the clinical encounter," Giordano added. "This allows clinicians to most accurately inform patients about available and recommended treatments, which strengthens patient autonomy in their capacity to make informed decisions about their care."

Although Switaj remains a staunch supporter of EBM, he understands there is still much to learn in the vast world of medicine and EBM may not be valuable in all patient-care encounters.

"Since there is still so much about medicine we don't know and are learning every day, we do not have good evidence-based medicine guidelines for everything, he said. "Thus these principles should be used as a guide with considerations for warranted variance as needed."

Registration is now open for Giordano's EBM presentation. This CCSS will take place virtually thorough Adobe Connect. Participants can earn up to 6.5 continuing education/continuing medical education CE/CME credits if all requirements are completed.

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