EBM, which means “evidence-based medicine,” is incorporated when deciding on a treatment plan.

There is an abundance of treatment methods, ranging from folk remedies to methods based on the latest research data. Let’s take a look at the definition, history, and specific flow of EBM, which is important when considering which to choose and which to believe.

EBM refers to Evidence-Based Medicine

EBM is an acronym for “Evidence-Based Medicine.”

Choosing a treatment method based on a medical professional’s previous experience, intuition, recommended by authority figures, or methods that are not scientifically proven may not only be ineffective, but may even have negative effects on the patient.

EBM is important to prevent these from happening, and to select treatment methods that have reliable evidence, such as concrete data and methods with objective results, and to tailor the treatment to the patient.

Overview and definition of EBM

EBM has been defined as consisting of three elements.

The first is evidence from clinical research.
Treatment methods developed based on past experience without evidence cannot be incorporated into EBM.

The second is the patients’ sense of values.
No matter how effective a treatment may be, we cannot force it if it does not meet the patient’s values. There are treatments that work quickly but have strong side effects, treatments to prolong life that the patient and people around do not want, and treatments that require high treatment costs that the patient cannot afford.

And the third is the proficiency and expertise of the medical professionals.
The treatment should not be judged only by the experience of the medical professional. It is the job of medical professionals to come up with treatment methods that match the values of the patient based on evidence-based treatment methods.

Even when referring to the same data, the treatment that can be given is completely different depending on the country, religion, culture, and economic situation. The practice of forcing treatment based solely on evidence without respecting the will of the patient is sometimes ridiculed as “tyranny by evidence”.

History of EBM

EBM was proposed in 1991.
Until then, many medical practices were based on treatments that had been performed or advocated by people who were considered experts or predecessors without any scientific basis.

For example, in the past, many infants died as a result of the dissemination of unsubstantiated information recommending that putting an infant to sleep face down, and there have been various problems worldwide.

In the midst of all this, Gordon Henry Guyatt used the term EBM for the first time and explained the importance of science-based treatment.

The flow of EBM

Now, we would like to explain the flow of EBM.

The first step is to identify questions about specific treatments and tests.
The next step is to find literature that addresses the question and carefully check the quality of evidence in that literature.

Use reliable literature as a reference for treatment methods, etc., and make sure to perform more effective treatments, tests, and research.

Extraction of Questions

In the extraction of questions, we identify specific questions that will come up in deciding the future course of treatment, such as “what effect will this drug have on the patient’s disease and symptoms?” and “what testing methods will be useful in clarifying the name of the disease based on the patient’s symptoms?”

It would be more effective if the actual names of the drugs and testing methods were used in this process.

Search for high quality clinical research

Search for clinical researches and literature to clear up any questions that arose. It is important to select studies that have been conducted according to specific evidence-based guidelines and that have been proven to have a scientific basis.

There are a huge number of medical papers, and it is not uncommon for the results and processes to be completely different among medical professionals and experts. Among them, we search for reliable data.

Evaluation of the quality of evidence

Whether the data is correct or not cannot be judged just because it follows the guidelines or because the researcher is an expert in the field. It is necessary to check the points that should be examined by yourself.

It is important to see how high the quality of the evidence is by checking the details, such as whether the guidelines are correct in the first place, whether the number of data collected is trustworthy, and whether the literature is not too old.

Consider applying to patients

Data from reliable literature and treatment methods are explained to the patient to be treated. If the patient is satisfied with the treatment method, the treatment can be started.

Since the results and treatments may not be what the patient wants, health care providers must choose among evidence-based treatment methods that can be considered the best for the patient.

Flow of database construction using EBM

Next, let’s discuss how EBM is built into a database, and what kind of information is available in the database for medical professionals to refer to.

De-identification at medical institutions

First, each medical institution conducts anonymization processing to the data. In this way, the patient’s name, date of birth, place of birth, and current address can be withheld from other medical professionals when they read the data. The patient’s personal information will not be leaked to the outside world.

Data submission

Submit anonymously processed data to a database.

It is important to determine which system to provide the data to because there are many different systems. Systems are used by users for a variety of purposes, such as for treatment decisions, product strategies, and for writing papers. It is necessary to determine which user group is most likely to use the system.

Database construction

The provided data will be stored in a database.
The database is built up with a lot of data and can be accessed by medical institutions, pharmaceutical companies, and medical device manufacturers.

Used for marketing research and clinical research

Medical institutions, pharmaceutical companies, medical device manufacturers, etc. will browse the data that is constructed.

Search for data constructed to address questions about treatments, symptoms, etc., which are identified in the first step of EBM, and pick up data that is evidence-based.

The data is then used for marketing research and clinical research. In addition, the data can be incorporated into treatment methods or used as references in research papers.

Case Studies of EBM

Let’s take a look at case studies of EBM to reconfirm the importance of the EBM concept in various situations.

An example that is easy to understand is the use in pharmaceutical companies.

Case studies in pharmaceutical companies

In order to develop a new drug or improve an existing drug in a pharmaceutical company, a huge amount of data is needed. It is also necessary to conduct clinical trials before a drug is actually completed, but for this, evidence-based effects and side effects must first be confirmed.

In doing so, it is important to search for evidence-based data and incorporate it into the development process.

Furthermore, medicine is not something that can be made quickly. It takes many years to complete. Analyzing the data beforehand will help you in your marketing research, such as how much you can sell this medicine in that field, and how much demand there is for it.

Using EBM to make more accurate decisions

Even now, medical professionals sometimes treat patients based on their experience and intuition, but this may lead to serious medical mistakes.

It is important to refer to scientific evidence-based treatment and testing methods to make a more accurate diagnosis.

Let’s try to treat and diagnose patients according to these three elements: evidence-based data, patients’ values, and healthcare professionals’ experiences.