Word: guyatt
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Advocates believe that evidence-based medicine can go much further, reducing the reliance on expert opinion and overturning the flawed assumptions and even financial incentives that underlie many decisions. "This is a whole way of looking at the world," says Dr. Gordon Guyatt of McMaster University in Hamilton, Ont., who coined the term and is a pioneer of the evidence-based movement...
Whatever the merits of evidence-based medicine, it got off to a rocky start. When Guyatt began championing it back in the 1990s, he called it "scientific medicine," but he learned quickly that if you want to start a revolution, it helps to pick the right slogan. Many of his colleagues were outraged by the implied insult to their expertise. So he quickly went with "evidence-based," and tempers cooled...
...Guyatt's ideas complemented the work of the Cochrane Collaboration, an international network of researchers, physicians and others that was founded in 1993 to systematically gather and evaluate the knowledge found in medical research. The organization aggregates all published scientific studies on a particular treatment question to get a sense of the field. Then reviewers carefully consider the design of the research to determine just how strong the evidence is. One of their most famous reports was a 2005 finding based on 139 studies showing that there was "no credible evidence" that the vaccine against measles, mumps and rubella...
...Guyatt and another doctor, David Sackett, wanted to go a step further by making sure doctors used the evidence that was collected and ranked. Many physicians began doing just that, but there have been a few nasty surprises...
...practice will have the most emotional impact. All patients would probably benefit if their doctors were abreast of the latest data, but none would benefit from being reduced to one of those statistical points. "You have to be able to take a good history and do a physical examination," Guyatt says. "And you have to have an understanding of patients' values and preferences." As much as some physicians might wish it otherwise, there is still as much art to medicine as there is science...