Understanding why we agree on the evidence but disagree on the medicine.
Despite the fact that physicians, nurses, and respiratory therapists share a common training in scientific evidence and frequently share a common understanding of the evidence, debates occur about the proper management of individual patients. Clinicians may interpret this as a failure of evidence-based medicine, when, in fact, evidence is only one of many factors that play a role in clinical decision-making. By clearly understanding the other factors that affect clinical decision making-prior beliefs about treatment effectiveness, patient and clinician values, and clinical expertise-clinicians can better understand which clinical disagreements are about scientific evidence and which are about other factors.
Rubenfeld
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Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, Washington 98104, USA. nodrog@u.washington.edu
D001291:Attitude of Health Personnel; D003657:Decision Making; D019317:Evidence-Based Medicine; D006801:Humans; D010818:Practice Patterns, Physicians'; D012120:Respiration Disorders / Q000628:therapy*