Evidence-Based Medicine Matters

Professor John Wattis

Professor of Old Age Psychiatry

Evidence-based medicine is a vital component of good clinical practice. The evidence base shows the importance of clinician-patient and wider social relationships and these must not be ignored. Nor should the importance of a creative synthesis of ideas in forming individual treatment plans be underestimated. The absence of evidence of effectiveness is not the same as evidence of absence of effectiveness. However, good clinical practice demands that we search for and develop evidence of efficacy and effectiveness and select treatment options according to the best evidence available. You will see from the above that I do not think a narrow "evidence-based" approach is adequate. We must embrace evidence about how we practice medicine as well as the narrower and more precise evidence about what treatment works in what groups of conditions; but without an evidence base clinical practice is like a rudderless ship adrift in an ocean and tossed this way and that by the currents of prevalent fashion!