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Comparative Effectiveness ResearchEvidence, Medicine, and Policy$
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Carol M. Ashton and Nelda P. Wray

Print publication date: 2013

Print ISBN-13: 9780199968565

Published to Oxford Scholarship Online: September 2013

DOI: 10.1093/acprof:oso/9780199968565.001.0001

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Doctors and Evidence

Doctors and Evidence

Evidence-Based Medicine

(p.97) 5 Doctors and Evidence
Comparative Effectiveness Research

Carol M. Ashton

Nelda P. Wray

Oxford University Press

Evidence-based medicine is clinical care guided by the best-available scientific evidence generated from clinical research linked with the clinical acumen of the individual physician. It is built upon the principles of clinical epidemiology, and requires the physician to collect valid, reliable, and complete data from the patient, and in turn, use external evidence from clinical research to guide the patient’s care. Ways have been developed to help doctors deal with the explosion in the volume of clinical literature, evaluate the quality of individual studies, synthesize evidence from multiple studies addressing the same clinical question, and judge the applicability of the literature to the individual patient at hand. Methods have also been developed for the creation of clinical practice guidelines, but such guidelines can be undermined by financial conflicts of interest. The greatest challenge, however, is in getting physicians and patients to apply the evidence in clinical practice.

Keywords:   Alvan Feinstein, David Sackett, Archie Cochrane, Iain Chalmers, Cochrane Collaboration, Systematic reviews, Clinical practice guidelines, Conflict of interest in medicine

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