Medicina basada en la evidencia:: lo que es y no debería ser

Abstract

Background: the MBE is defined as "the conscientious, explicit and judicious use of the best scientific evidence available to make decisions about patients." Objective: introducing the concept of evidence-based medicine (EBM), its applicability in clinical practice and its difficulties as a tool. Methodology: we did a literature search in the following databases: MEDLINE, LILACS, SciELO, and Cochrane CENTRAL LIBRARY, with the following search strategy "evidence-based medicine" [MeSH Terms] OR ("evidence-based" [All Fields] AND "medicine" [All Fields]) OR "evidence-based medicine" [All Fields] OR ("evidence" [All Fields] AND "based" [All Fields] AND "medicine" [All Fields]) OR " evidence based medicine "[All Fields], the search strategy was adapted for each of the databases previously proposed. The searches yielded 4516 primary studies were selected by title and abstract 102, of which 52 were selected methodological quality of these 14 were selected for relevance of the topic with respect to the objectives of this review. Results: the MBE considers the scientific method as the best tool today to know the reality and express it in understandable and concise. Supports the development of reasoning and a method that aims to transform clinical data into knowledge scientifically valid, statistically accurate and clinically relevant for modern medical practice. He claims that the medical practitioners, in addition to their experience and clinical skills, able to apply properly the results of scientific research to improve the quality of medical practice. The process involves the identification of uncertainty in clinical decision-making, subsequently the formulation of well-structured clinical questions, systematic and efficient search of evidence which provides a critical assessment of its quality, the interpretation of results and implementation of research findings to decision-making. Conclusions: the MBE provides a conceptual framework for clinical problem solving, bringing data from clinical research to medical practice, however, and presents a critical point is the lack in most scenarios of external validity at the time of application of evidence found.