[The role of epidemiological evidence in providing care for individual patients].
Evidence-based medicine is increasingly being viewed as a sine-qua-non for the modern and high-quality practice of medicine. 'Evidence' refers to the availability of epidemiological research. In this paper, we discuss a number of limitations of over-emphasis on epidemiological evidence. We focus on the availability, reliability and applicability of epidemiological evidence in the context of individualised medicine. We conclude that relying excessively on epidemiological evidence is a danger that we are insufficiently aware of. The implications of our conclusions for patient care and health policy are discussed. We propose that epidemiological evidence should be used for benchmarking average care provided by doctors working alone or in group practices, but not for benchmarking care provided to individual patients.
Smulders
Yvo M
YM
VU Medisch Centrum, afd. Inwendige Geneeskunde, Amsterdam, The Netherlands. y.smulders@vumc.nl
Levi
Marcel
M
Stehouwer
Coen D A
CD
Kramer
Mark H H
MH
Thijs
Abel
A
D019985:Benchmarking; D016021:Epidemiologic Studies; D019317:Evidence-Based Medicine; D006801:Humans; D011787:Quality of Health Care