The importance of values in evidence-based medicine

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.

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

Contributors

Michael P. Kelly: [e-mail]

Iona Heath: [e-mail]

Jeremy Howick: [e-mail]

Trisha Greenhalgh: [e-mail]

Journal

Journal ID (nlm-ta): BMC Med Ethics

Journal ID (iso-abbrev): BMC Med Ethics

Title: BMC Medical Ethics

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6939

Publication date (Electronic): 12 October 2015

Publication date PMC-release: 12 October 2015

Publication date Collection: 2015

Volume: 16

Publisher ID: 63

DOI: 10.1186/s12910-015-0063-3

PMC ID: 4603687

PubMed ID: 26459219

Copyright statement: © Kelly et al. 2015

License:

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.

Categories

Subject: Debate

Custom metadata

issue-copyright-statement © The Author(s) 2015