Spoiler: Unfortunately, maybe.

Evidence-based medicine – what is it? And how could it be otherwise?

Spoiler: Unfortunately, maybe. And this does not mean that that other medicine is “wrong” – perhaps it can even help someone. Doctors, guided by the principles of the so-called "impressionist" (from impression – impression) approach, put their experience at the forefront. On the one hand, this is good: the doctor, a specialist with extensive clinical practice, does not reinvent the wheel and does not treat each patient “in a new way”, but uses methods that have been proven and proven over the years, which once helped him with more than one patient. On the other hand, medicine – like any science – does not stand still, which means that every year (if not monthly) its methods are improved, doctors improve their experience, gather at conferences and congresses, where they also share their experience, and in scientific journals publish meta-analyses that can correct the doctor's idea of ​​"beautiful". If the doctor does not follow this, but prefers to treat "the old fashioned way", then his patient is at least threatened only with a longer recovery, and at the maximum – unpleasant side effects that could have been avoided.

For example, earlier a headache was treated with a decoction of oak bark – the fact is that it is from it that the component that underlies modern aspirin can be synthesized. The problem, however, is that in the case of the "improvised" remedy, it is impossible to accurately calculate the required dosage – and in fact for each patient it can be different. An "impressionistic" doctor who once used oak bark to treat a patient will prescribe it to everyone – and certainly will not do without ignoring the individual characteristics of the body of each patient.

Another thing is evidence-based medicine, in the case of which the doctor never tries to apply a single methodology to everyone. The phrase “it helped others and it will help you” does not work here, because the doctor knows that each case is unique, and each patient is not a mechanical set of organs and diseases distributed according to the same principles and the same model. This means that in order to cure a patient, it is not enough just to apply what happened with the previous ones – you need to adapt the existing methods to the characteristics of the body of a particular person. And the source of these techniques will not be personal experience, but serious studies that are constantly published in scientific journals and tested daily on millions of patients. The doctor's goal in this case is not to cure the patient by what has helped others, but to find the method of treatment that will be most safe and effective for him. Refer to your personal experience (become "impressionists" for a moment!): surely among your acquaintances there are people who were ill with the same disease.Turning to them for friendly advice, you can hear completely different things – not because one was treated by a good doctor, and the other by a bad one, but because, probably, their organisms are completely different: what helped one might not help the second, as a result, a different dosage of the drug or treatment was chosen. People with a weak cardiovascular system will never be prescribed drugs whose side effects can harm them. A modern doctor, guided by the principles of evidence-based medicine, will always give preference to proven research results, rather than personal experience.

But where do these principles come from?

The father of evidence-based medicine, David Lawrence Sackett, formulated the basic principles of this direction in the early 90s of the twentieth century:

• the individual clinical experience of the doctor (of course, one cannot do without experience – only in making a decision it is far from being given the first place);
• external evidence – scientific work on which the specialist relies when making a diagnosis;
• values ​​and expectations of the patient – when making decisions, the doctor, among other things, is guided by the wishes of the patient.

How do I know that the doctor I went to really adheres to the principles of evidence-based medicine?

Firstly, many doctors today go online – they maintain their blogs and pages on the websites of medical institutions, where they share the achievements of evidence-based medicine and tell patients about these techniques. But here you need to be careful: sometimes pseudo-specialists can hide behind this, who in fact prescribe drugs from the so-called hit list of drugs with unproven effectiveness. Evidence-based doctors call such drugs "fuflomycins" – they have not passed the necessary clinical studies, and in modern authoritative sources and recommendations there are no data that would confirm their effectiveness. Be sure to study this list – if you are prescribed any of these false drugs, then it's time to start doubting the competence of a specialist – even if hundreds of thousands of people subscribe to his Instagram profile, and he calls himself a professional. For example, the widely prescribed (unfortunately) -ferons ("Ergoferon", "Cycloferon", etc.), "Oscillococcinum", "Ingavirin", "Kagocel" and so on – nothing more than a "divorce" for money, which allegedly promises you a cure for SARS. As they say, if you treat a “cold”, then it will pass in a week, if you do not treat it, then in seven days.

However, it is better to see once than hear a hundred times – this principle also works in medicine. Many advise specialists because “it helped them”, but whether it will help you can only be assessed in person. If the doctor adheres to the principles of evidence-based medicine, then he will never prescribe homeopathic remedies for you and will not insist that you need to “raise” your immunity.When diagnosing, he will explain at your request why you are appointed by one or another method of treatment or examination, and will also refer to scientific sources.