This twitter account, @enferevidente, specializing in clinical safety, has offered us the link to a paper on the history of the EBM which is a jewel in itself. If you click on the tweet, you may access a collaboratively edited video from the British Medical Journal and The JAMA Network. It’s a chat, moderated by Richard Smith, where Gordon Guyatt, Kay Dickersin, Drummond Rennie, Brian Haynes and Paul Glasziou – all ‘parents’ of EBM. There are also connections with David Sakkett, Iain Chalmers and Muir Gray. If you wish to press the play button (do it through the link in the tweet), you will see how veteran scientists explain their conversion to the, new (at that time) way of seeing clinical research, along with their views on the current circumstances.
The future of EBM from its "parents"
What interested me most, however, was the last round of the chat, when Richard Smith questions the guests about how they see the future of EBM and clinical practice, and on this I made some notes as follows:
Last century belonged to the doctor; this one should belong to the patient. Today’s doctors have a good available training, evidence and proven technology that we had never dreamed of. Now they need to know how to lead a clinical practice adjusted to the values of each patient.
The challenge of the future will be to make sure that good quality information reach the professionals clearly.
I expect more clinical leadership, higher quality research and better contrasted publications from the future, and much more research on clinical safety.
We should understand that research is a learning process and, sometimes, in order to obtain first-rate projects, we must invest time and money in projects that fall by the wayside.
We should continue focusing on clinical evidence-based training, further enhance systematic reviews and invest more in tools that help patients in decision making.
Three ideas: a) more transparency in the whole process of research, from clinical uncertainty that raises the question to the implementation of the results in the office, b) streamline the methodology of systematic reviews in order to provide consistent and fast information during the work, and c) expanding clinical trial methodology to all aspects of clinical practice, and not just stick to the pharmaceutical as it happens now.