Journal
PATIENT EDUCATION AND COUNSELING
Volume 73, Issue 3, Pages 407-412Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2008.07.054
Keywords
Evidence Based Medicine; Shared Decision Making
Funding
- School of Public Health, University of Sydney, Australia
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Evidence Based Medicine (EBM) and Shared Medical Decision Making (SDM)are changing the nature of health care decisions. It is broadly accepted that health care decisions require the integration of research evidence and individual preferences. These approaches are justified on both efficacy grounds (that evidence based practice and Shared Decision Making should lead to better health outcomes and may lead to a more cost-effective use of health care resources) and ethical grounds (patients' autonomy should be respected in health care). However, despite endorsement by physicians and Consumers of these approaches, implementation remains limited in practice, particularly Outside academic and tertiary health care centres. There are practical problems of implementation, which include training, access to research, and development of and access to tools to display evidence and Support decision making. There may also be philosophical difficulties, and some have even suggested that the two approaches (evidence based practice and Shared Decision Making) are fundamentally incompatible. This paper look at the achievements of EBM and SDM so far, the potential tensions between them, and how things might progress in the future. (C) 2008 Published by Elsevier Ireland Ltd.
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