Ralph I Horwitz1, Mary E Charlson2, Burton H Singer3. 1. Temple Transformative Medicine Institute, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA. 2. Weill Department of Medicine, Weill Cornell Medical College, New York, NY, USA. 3. University of Florida, Gainesville, FL, USA.
Abstract
BACKGROUND: For the past 70- years patient care has been dominated by Evidence Based Medicine (EBM) with its emphasis on Randomized Controlled Trials (RCTs) and clinical guidelines to standardize medical decision-making. METHODS: Critical assessment of the literature and analyses of the arguments that favor patient care based primarily on individual variability in disease risk or treatment response versus emphasis on group standardization. RESULTS: Medicine Based Evidence (MBE) is used to guide decision making for an individual patient at hand by profiling the clinical features (biology) and life experience (biography) of the patient and then finding approximate matches to the patient in a clinical library of patients assembled from diverse sources (RCTs, cohorts, registries, electronic health records and more). CONCLUSION: Medicine is transitioning from population based model of clinical care that relies on average results from RCTs to an individual-based model of "personalized" medicine. For individualized care of the patient at hand, MBE is the preferred scientific strategy to generate evidence for patient care.
BACKGROUND: For the past 70- years patient care has been dominated by Evidence Based Medicine (EBM) with its emphasis on Randomized Controlled Trials (RCTs) and clinical guidelines to standardize medical decision-making. METHODS: Critical assessment of the literature and analyses of the arguments that favor patient care based primarily on individual variability in disease risk or treatment response versus emphasis on group standardization. RESULTS: Medicine Based Evidence (MBE) is used to guide decision making for an individual patient at hand by profiling the clinical features (biology) and life experience (biography) of the patient and then finding approximate matches to the patient in a clinical library of patients assembled from diverse sources (RCTs, cohorts, registries, electronic health records and more). CONCLUSION: Medicine is transitioning from population based model of clinical care that relies on average results from RCTs to an individual-based model of "personalized" medicine. For individualized care of the patient at hand, MBE is the preferred scientific strategy to generate evidence for patient care.
Authors: Amit P Amin; Sunil V Rao; Arnold H Seto; Manoj Thangam; Richard G Bach; Samir Pancholy; Ian C Gilchrist; Prashant Kaul; Binita Shah; Mauricio G Cohen; Ty J Gluckman; Anna Bortnick; James T DeVries; Hemant Kulkarni; Frederick A Masoudi Journal: Circ Cardiovasc Interv Date: 2021-07-13 Impact factor: 6.546
Authors: Satriya Pranata; Shu-Fang Vivienne Wu; Javad Alizargar; Ju-Han Liu; Shu-Yuan Liang; Yu-Ying Lu Journal: Int J Environ Res Public Health Date: 2021-06-17 Impact factor: 3.390