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Misconception about evidence based medicine (EBM)

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(@prof-kishor-patwardhan)
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There is a widespread misconception about evidence based medicine (EBM). Many view prescribing some pills and injections that have undergone clinical trials as the only meaning of EBM, which is not only wrong but also could be misleading.
 
In fact, EBM has three pillars and each of these three is equally important:
 
1. Patient's preferences and values
2. Physician's experience and clinical judgement
3. Most updated published evidence 
 
One needs to understand that clinical trials, systematic reviews, meta-analyses etc produce the evidence that fulfills only one of these three requirements. Hence, that is not the only meaning of EBM.
 
Now that many of us, including me, want to see Ayurveda to become evidence based, we need to understand this context clearly.
 
When a patient visits an  Ayurveda physician, the first requirement usually gets fulfilled, as that is patient's choice/ preference. "Usually" because sometimes this choice could be uninformed. 
 
Physician's personal experience and clinical judgement fulfills the second requirement, but is based on how experienced a physician truly is. 
 
The third requirement is the one that largely remains unfulfilled in such cases, because, many a times we do not have high quality evidence in the form of clinical trials etc. 
 
Those who support the idea of evidence based Ayurveda need to know this. 
 
Hence, an argument such as "This particular treatment has been documented in ancient textbooks and therefore serves as good evidence" is not a valid one.
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