Since the idea of evidence-based medicine was first formulated over 20 years ago, this paradigm has seen numerous successes in improving patient care, based on the synthesis of high quality clinical research combined with medical expertise and patient wishes. However, concerns have arisen over some of it’s unintended consequences, from misappropriation of this term, to issues around the accessibility of the wealth of data being produced.
In an effort to stimulate debate over how these concerns can be overcome, Trisha Greenhalgh from the Bart’s and the London School of Medicine and Dentistry, UK, Neal Maskrey from Keele University, UK, and colleagues have launched a campaign for ‘real evidence-based medicine’, as announced by Greenhalgh at the 2014 Health Services Research conference hosted by BioMed Central and published in their article in the British Medical Journal (BMJ. 2014, 348:g3725). In this video Q&A with Greenhalgh and Maskrey, they explain more about the campaign, discuss the key problems with current evidence-based research, and explore the role medical education has to play.
“Real evidence-based medicine doesn’t replace compassionate, individualised care with a standardised one size fits all management protocol. [...] It’s about making expert clinical judgements in conversation with patients taking account of evidence.”
Trish Greenhalgh, the Bart’s and the London School of Medicine and Dentistry
Trish Greenhalgh is actively engaged in primary healthcare research at the interface between sociology and medicine, as well as holding a position as a non-principal general practitioner. She received her medical degree at Oxford University, UK, before pursuing a career in laboratory science and later retraining as a general practitioner. Upon joining Barts and the London School of Medicine and Dentistry, Greenhalgh set up the Healthcare Innovation and Policy Unit within the Centre for Primary Care and Public Health, where she takes an interdisciplinary approach to probe complex, policy-related issues in modern healthcare.
“In every consultation there are two people involved in making the decision. The clinician has his own expertise and the patient has their own expertise. What we want to see is a rebalancing of that power in those conversations.”
Neal Maskrey, Keele University
Neal Maskrey’s career began in general practice, before he went on to become a medical manager, and later Director of the National Prescribing Centre and Programme Director at the UK National Institute of Health and Clinical Excellence (NICE). Maskrey is now Professor of evidence-informed decision making at Keele University, UK, and a consultant clinical adviser in the NICE Medicines and Prescribing Centre.