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I don't know who needs to hear this but
JUST
Following guidelines ≠ EBM .
Let's talk about practice and Evidence based Medicine #IndianMedTwitter
India is a place where community practice largely depends on what one learns from textbooks, teachers and experience. 1/n
JUST
Following guidelines ≠ EBM .
Let's talk about practice and Evidence based Medicine #IndianMedTwitter
India is a place where community practice largely depends on what one learns from textbooks, teachers and experience. 1/n
Staying updated and in sync with the standard of care in western countries has been a huge challenge for the overworked, overburdened Indian doctors who didn't have access to journals/ conferences.
Though now the trend is changing for the better. 2/
Though now the trend is changing for the better. 2/
Our generation of younger enthusiastic doctors are luckier and privileged to have information and the world at our fingertips.
Despite not having enough resources and time to conduct trials, we have access to the newest trials and data from across the globe. 3/
Despite not having enough resources and time to conduct trials, we have access to the newest trials and data from across the globe. 3/
And the easiest way out is following guidelines ( American or European) which are updated based on recent studies and approvals.
So the ones who follow guidelines hail themselves as the 'brand ambassadors' of EBM, which may not necessarily be a good thing. 4/
So the ones who follow guidelines hail themselves as the 'brand ambassadors' of EBM, which may not necessarily be a good thing. 4/
Following guidelines is better than staying outdated, it is a step forward from conservative medicine to mediocrity.
But True EBM encompasses
1) Development of a scientific acumen to understand& critically analyse trials, evaluate the risk/benefit ratio, clinical endpoints. 5/
But True EBM encompasses
1) Development of a scientific acumen to understand& critically analyse trials, evaluate the risk/benefit ratio, clinical endpoints. 5/
2) Understanding the economics of medicine & the economics of policy making.
3) Acknowledging the different goals of various health systems and their guidelines.
4) Deciphering the politics behind approvals, the pharma and insurance lobbies. 6/
3) Acknowledging the different goals of various health systems and their guidelines.
4) Deciphering the politics behind approvals, the pharma and insurance lobbies. 6/
5) After considering all the factors, choose the options you think are clinically relevant, discuss the statistics & outcomes as lucidly as possible with the Patients & empower them to make a well informed decision based on their socio-economic status that ensures compliance. 7/
We have been doing this regularly for our cancer patients but there are limitations which can be overcome by filling these caveats.
Formulation of
a)National Guidelines which are updated and tailored as per the needs of our population.
b)Verified Authentic Patient resources
8/
Formulation of
a)National Guidelines which are updated and tailored as per the needs of our population.
b)Verified Authentic Patient resources
8/
Authentic patient reference resources, help Pts understand the std &goals of care, expected side effects & benefits in a simple language.
This would encourage them to NOT seek alternate solutions from whatsapp/Google/hearsay, will also ensure more trust & less litigations. 9/
This would encourage them to NOT seek alternate solutions from whatsapp/Google/hearsay, will also ensure more trust & less litigations. 9/
