Can you provide examples of how evidence-based medicine has positively impacted patient outcomes or healthcare practices?

Article Understanding Evidence Levels in Evidence-Based Medicine: A ...

Evidence-based medicine (EBM) has had a significant positive impact on patient outcomes and healthcare practices across various clinical specialties. Here are some examples:

Reduction in Mortality and Morbidity: Implementation of evidence-based guidelines and protocols for acute myocardial infarction (heart attack) management, such as timely administration of aspirin, thrombolytics, and percutaneous coronary intervention (PCI), has led to significant reductions in mortality rates and complications associated with myocardial infarction.

Improved Cancer Screening and Treatment: Evidence-based screening guidelines for breast, colorectal, cervical, and prostate cancers have increased early detection rates, leading to earlier diagnosis, more effective treatment interventions, and improved survival outcomes for patients with cancer.

Prevention of Healthcare-associated Infections: Adherence to evidence-based infection prevention and control practices, such as hand hygiene protocols, aseptic techniques, and appropriate use of antimicrobial agents, has resulted in reductions in healthcare-associated infections (HAIs) and related morbidity and mortality rates in hospitals and healthcare facilities.

Enhanced Surgical Outcomes: Adoption of evidence-based surgical practices, including preoperative optimization, surgical checklists, enhanced recovery after surgery (ERAS) protocols, and minimally invasive surgical techniques, has led to improvements in surgical outcomes, shorter hospital stays, and reduced postoperative complications for patients undergoing surgery.

Management of Chronic Diseases: Evidence-based management strategies for chronic diseases such as diabetes, hypertension, asthma, and chronic obstructive pulmonary disease (COPD) have improved disease control, reduced disease progression, and prevented complications, resulting in better quality of life and health outcomes for patients with chronic conditions.

Reduction in Medication Errors: Implementation of evidence-based medication reconciliation processes, computerized physician order entry (CPOE) systems, clinical decision support tools, and pharmacist-led medication therapy management programs has helped reduce medication errors, adverse drug events, and medication-related hospitalizations.

Promotion of Patient Safety and Quality Improvement: Integration of evidence-based patient safety practices, such as standardized protocols for handoffs and communication, checklists for surgical procedures, and root cause analysis of adverse events, has contributed to improvements in patient safety culture, reduction in medical errors, and enhancement of healthcare quality and reliability.

Optimization of Maternal and Neonatal Health: Evidence-based practices in obstetrics and neonatology, such as antenatal screening, intrapartum monitoring, use of evidence-based protocols for labor induction and cesarean section, and implementation of neonatal resuscitation guidelines, have improved maternal and neonatal outcomes, reduced maternal and infant mortality rates, and enhanced perinatal care.

Overall, evidence-based medicine has revolutionized healthcare practices by providing clinicians with the tools, knowledge, and guidelines needed to deliver high-quality, patient-centered care, improve clinical outcomes, and enhance patient safety and satisfaction across diverse clinical settings and patient populations.

Suraj Kapoor

Evidence-based practice has been consistently linked to improved quality of care, patient safety, and many positive clinical outcomes across various healthcare settings. Specific examples include:

Implementing evidence-based interventions to reduce catheter-related bloodstream infections in the ICU
Improving door-to-balloon time for heart attack patients, which reduced mortality and improved outcomes.
Applying evidence-based quality improvement interventions directed at cancer specialists, which led to improvements in cancer care delivery.

Suraj Kapoor

Evidence-based medicine (EBM) has had a significant impact on patient outcomes and healthcare practices, as demonstrated by various research studies. Here are some examples of how EBM has positively influenced healthcare:

The implementation of various EBPs, particularly those involving infection prevention, was linked to reimbursement, and the majority of studies reported a positive return on investment. Notably, the two most reported outcomes were a reduction in the length of stay and mortality rates.

This robust environment for comparative effectiveness research and systematic reviews is expected to lead to improved quality of care through the implementation of evidence-based medicine

Vinod Kumar Gupta

How wrong the leap of faith through RCT can be, misdirecting researchers for millennia:

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06-August-2023

ORCID-Id: 0000-0002-6770-5919

Vinod Kumar Gupta

Error is intrinsic to human endeavor, statistical or non-statistical. Falsehood flies while truth comes limping much later. The credibility our research efforts depends on exclusively and meticulously following a disinterested pursuit of the truth in a non-compete fiscally-unrelated environ, a readiness to acknowledge error and to correct course of the approach, along with an overriding quest for new and replicable knowledge free from arbitrary consensus, in particular reproducibility of pharmacokinetics [Gupta, 2019; Ioannidis, 2019; Kassirer, 1993].

For reasons that can still not be scientifically teased apart satisfactorically, the manuscript that claimed that aspirin prolongs bleeding time was turned down [Desforges, 1993]. Additionally, therapeutic replication is intrinsically difficult in any migraine cohort because of the protean nature of the disorder, with a wide variety of triggers – single or cumulative, tangible or intangible -- and a headache phase lasting between 4-72 hours or longer while the pre-prodromal phase may last weeks, to months, to years, to decades. In the last five decades or more, much of published medical science is false, with statistical significance blurring biological / bioclinical significance and propelling ‘false discoveries’ [Howick, et., 2022; Ioannidis, 2019, 2005; Amrhein, et al., 2019; Mellis, 2018; Gupta, 2010]. According to the American Statistical Association, the P-value does not indicate independent or unchallengeable clinical significance (Wasserstein and Lazar, 2016). Continued use of the p value still appears to be a necessary drawback, even with lower values [Ioannidis, 2018].

Chance, in many forms, has become lost in data surrounding bias or prejudice, overt or covert. The quest for quantitative statistical truth has introduced and buttressed a façade of mathematical acceptability in bioscience or biomedicine that risks drawing the clinician / researcher away from clinical reality and commonsense / face-validity [Feinstein, 1994, Horton and Kendall, 1991].

Part of the manuscript:

The 'pre-prodromal' or ‘pre-premonitory’ phase of migraine holds the key to the cause-effect pathophysiological-functional basis of the disease buried over 25 Centuries well into the Third Millennium. (Pre-print available on Research-Gate)

06-August-2024

ORCID iD: 0000-0002-6770-5916

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