One of the main purposes of clinical decision support software and similar tools is evidence-based medicine — an objective, data-driven approach to delivering the best care to a patient. However, evidence-based medicine is not without its flaws, according to a recent article in the British Medical Journal.
In the article, three researchers from the Evidence Based Medicine Renaissance Group outline five problems that come with evidence-based medicine in the current healthcare environment.
1. Vested interests, such as the drug and medical device companies, often fund medical research. This means quality marks or guidelines based on this research may not represent the best clinical practice but rather the treatment option that benefits these companies.
2. The current volume of evidence, especially clinical guidelines, has become almost unmanageable.
3. Statistically significant benefits of one treatment over another may be marginal in clinical practice, but this information may not be included in CDS or other tools.
4. Inflexible treatment recommendations from evidence-based medicine tools may produce care that is management-driven rather than patient-centered.
5. Evidence-based guidelines often map poorly to complex cases where the patient has multiple co-morbidities.
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