Relevance of Evidence-Based Medicine (EBM) to Clinical Practice
A common storyline we are hearing these days is that physician adoption of clinical decision support tools and analytics in general is slow, often taking years to fully engage with new clinical decision support (CDS) systems. The concerns over clinician adoption are growing as data analytics become more commonplace with value-based care. The usual explanation for lagging adoption rates of EBM is blamed on the technology and the failure to integrate these tools and interfaces into clinical workflows in an efficient manner. This is certainly a major challenge, but there may be more to this than appears on the surface.
Scan some of the editorial pages of medical journals in recent years and you can find numerous debates over the relevance of evidence-based medicine to clinical practice hashed out in terms resembling the classic science vs. art of medicine debates. What we may be seeing is a deeper philosophical agreement between the use of statistics to guide clinical guidelines based on statistical means versus the n=1 challenge a physician faces when meeting an individual patient and understanding the context of the patient’s life.
This Domain Monitor digs deeper into this debate to see if there are other ways to frame the discussion and could open up ways for data science to uncover local patterns beyond global means that could provide physicians with the data they need to practice the art of medicine while also being scientifically based and evaluated. The timeliness of this debate is important; as interest in precision medicine and personalized approaches to therapy grows, we will need to manage the tensions that could possibly emerge between Population Health Management and the
world of n=1.