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      The importance of values in evidence-based medicine

      , , ,  

      BMC Medical Ethics

      BioMed Central

      Evidence-based medicine, Values, Medical ethics

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          Abstract

          Background

          Evidence-based medicine (EBM) has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.

          Discussion

          In this paper, we address this gap by demonstrating how a consideration of values can enhance every aspect of EBM, including: prioritizing which tests and treatments to investigate, selecting research designs and methods, assessing effectiveness and efficiency, supporting patient choice and taking account of the limited time and resources available to busy clinicians. Since values are integral to the practice of EBM, it follows that the highest standards of EBM require values to be made explicit, systematically explored, and integrated into decision making.

          Summary

          Through ‘values based’ approaches, EBM’s connection to the humanitarian principles upon which it was founded will be strengthened.

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          Most cited references 81

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          The structure of scientific revolution

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            Thinking Fast and Slow.

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              Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network

              Although current electronic methods of scientific publishing offer increased opportunities for publishing all research studies and describing them in sufficient detail, health research literature still suffers from many shortcomings. These shortcomings seriously undermine the value and utility of the literature and waste scarce resources invested in the research. In recent years there have been several positive steps aimed at improving this situation, such as a strengthening of journals' policies on research publication and the wide requirement to register clinical trials. The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is an international initiative set up to advance high quality reporting of health research studies; it promotes good reporting practices including the wider implementation of reporting guidelines. EQUATOR provides free online resources http://www.equator-network.org supported by education and training activities and assists in the development of robust reporting guidelines. This paper outlines EQUATOR's goals and activities and offers suggestions for organizations and individuals involved in health research on how to strengthen research reporting.
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                Author and article information

                Contributors
                mk744@medschl.cam.ac.uk
                iona.heath22@yahoo.co.uk
                jeremy.howick@phc.ox.ac.uk
                trish.greenhalgh@phc.ox.ac.uk
                Journal
                BMC Med Ethics
                BMC Med Ethics
                BMC Medical Ethics
                BioMed Central (London )
                1472-6939
                12 October 2015
                12 October 2015
                2015
                : 16
                Affiliations
                [ ]Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
                [ ]Royal College of General Practitioners, London, UK
                [ ]Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
                Article
                63
                10.1186/s12910-015-0063-3
                4603687
                26459219
                © Kelly et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2015

                Medicine

                evidence-based medicine, values, medical ethics

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