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Author's reply

Published online by Cambridge University Press:  02 January 2018

John Wallace*
Affiliation:
DPhil Reader in Evidence-Based Healthcare, Kellogg College, 62 Banbury Road, Oxford University OX2 6PN, UK. Email: John.wallace@wadh.oxon.org
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Abstract

Type
Correspondence
Copyright
Copyright © The Royal College of Psychiatrists 2012 

Ibrahimi is correct when he states that numbers and data, so much associated with evidence-based medicine, are not sufficient in dealing with the individual patient. Emotional insight, intuition and a caring attitude are also central.

The purpose of evidence-based medicine is not to replace clinical decision-making with numbers and data. Research evidence should be considered as one of many factors when making a clinical decision. Other elements to be utilised include intuition, clinical experience and, most important, the preferences of the patient. There are, of course, situations in which research evidence should be considered but then disregarded.

Sadly, medicine and psychiatry historically are littered with examples of interventions that were based on erroneous beliefs rather than evidence, many of which had less than optimal outcomes for the patient.

Currently, the push is on to make systematic reviews and research articles less of a quagmire. The emphasis is now on developing clear, readable summaries stressing conclusions and recommendations that are tailored to a specific target audience. Accessibility is becoming central. Evidence-influenced psychiatry is perhaps a better term to describe an approach that advocates consideration of research evidence as well as clinical experience and the patient’s preferences in a decision-making process that is aimed at advancing the patient’s best interests and their quality of care.

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