[Evidence-based and science-based medicine].
Routine medical practice is an admixture of scientific knowledge, uncontrasted physiopathological deduction and intuition based on personal experience. Evidence-based medicine is a new approach to medical practice that is based on appropriately contrasted data and includes the following steps: 1) accurately define the problem we are dealing with, 2) investigate the medical literature efficiently, and 3) select the best, relevant studies and apply the corresponding norms to the evidence. In turn, the application of the corresponding norms to the evidence includes the following aspects: 1) determine if the results of the study are valid; i.e., evaluate the scientific quality of the article, 2) determine the magnitude of the results; i.e., establish is they are clinically relevant, and 3) evaluate their application to the point at issue; i.e., test the external validity of the study. The drawbacks of evidence-based medicine include its insufficient concern for basic research, its disregard for physiopathological hypotheses, and the naïve inductivism of epidemiology-based medical practice. Undoubtedly, evidence-based medicine provides advantages for the medical practice and underscores the importance of data and statistical procedures. This new paradigm, however, should not set aside the traditional, hypothetical-deductive approach.
Salinas Casado
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J
Servicio de Urología, Hospital Clínico San Carlos, Universidad Complutense, Madrid. España.
Vírseda Chamorro
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M
D015510:Clinical Medicine / Q000266:history / Q000379:methods; D005069:Evaluation Studies as Topic; D019317:Evidence-Based Medicine; D049672:History, 19th Century; D010818:Practice Patterns, Physicians'; D012106:Research; D012586:Science
Medicina basada en la evidencia y en la ciencia.