Clinical expertise in the era of evidence-based medicine and patient choice
Evidence-Based MedicinePublished 1 March 2002Open access
R. Brian Haynes
Citations580
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TL;DR
A new model for evidence-based clinical decision making based on patients' circumstances, patients' preferences and actions, and best research evidence is presented, with a central role for clinical expertise to integrate these components.
Abstract
EBM notebookClinical expertise in the era of evidence-based medicine and patient choice ScenarioYou are caring for a 68 year old man who has hypertension (intermittently controlled) with a remote gastrointestinal bleed and non-valvular atrial fibrillation (NVAF) for 3 months, and an enlarged left atrium (so cardioversion is unlikely).The patient has no history of stroke or transient ischaemic attack.His father experienced a debilitating stroke several years ago and when he learns that his atrial fibrillation places him at higher risk for a stroke, he is visibly distressed. Patient preferences Research evidence Clinical expertiseFigure 1 Early model of the key elements for evidence-based clinical decisions 36
Keywords
Decision SciencesHealth ProfessionsEconomics, Econometrics and Finance
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