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Evidence based medicine in physical medicine and rehabilitation (English version)

Helmut Kern, Stefan Loefler, Veronika Fialka-Moser, Tatjana Paternostro-Sluga, Richard Crevenna, Samantha Burggraf, Hannah Fruhmann, Christian Hofer, Claudia Burmester, Benjamin Süsoy, Eva-Maria Strasser, Markus Praschak, Wolfgang Grestenberger, Friedrich Hartl, Gerold Ebenbichler, Günther Wiesinger, Thomas Bochdansky, Christian Wiederer, Michael Quittan
  • Helmut Kern
    Dept. of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna; Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria | wil.pys.kern-forschung@wienkav.at
  • Stefan Loefler
    Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
  • Veronika Fialka-Moser
    University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria
  • Tatjana Paternostro-Sluga
    University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria
  • Richard Crevenna
    University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria
  • Samantha Burggraf
    Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
  • Hannah Fruhmann
    Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
  • Christian Hofer
    Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
  • Claudia Burmester
    Dept. of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
  • Benjamin Süsoy
    Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
  • Eva-Maria Strasser
    Dept. of Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Vienna; Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria
  • Markus Praschak
    Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria
  • Wolfgang Grestenberger
    Fachgruppe Physikal. Medizin, Wiener Ärztekammer, Austria
  • Friedrich Hartl
    Bundesfachgruppe Physikal. Medizin, Österreichische Ärztekammer, Austria
  • Gerold Ebenbichler
    University Clinic of Physical Medicine, Medical University of Vienna; Berufsverband der Österreichischen Fachärzte für Physikal. Medizin und Rehabilitation (BÖPMR), Vienna, Austria
  • Günther Wiesinger
    University Clinic of Physical Medicine, Medical University of Vienna, Austria
  • Thomas Bochdansky
    Reha-Klinik Montafon, Schruns, Austria
  • Christian Wiederer
    Kurhaus Bad Gleichenberg, Bad Gleichenberg, Austria
  • Michael Quittan
    Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna; Dept. of Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Vienna; Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria

Abstract

In the last twenty years the term “Evidence Based Medicine (EBM)” has spread into all areas of medicine and is often used for decision-making in the medical and public health sector. It is also used to verify the significance and/or the effectiveness of different therapies. The definition of EBM is to use the physician’s individual expertise, the patient’s needs and the best external evidence for each individual patient. Today, however, the term EBM is often wrongly used as a synonym for best “external evidence”. This leads not only to a misuse of evidence based medicine but suggests a fundamental misunderstanding of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions, public healthcare providers and politicians use external evidence alone as a main guideline for financing therapies in physical medicine and general rehabilitation without taking into account the physician’s expertise and the patient’s needs.The wrong interpretation of EBM can lead to the following problems: well established clinical therapies are either questioned or not granted and are therefore withheld from patients (for example physical pain management). Absence of evidence for individual therapy methods does not prove their ineffectiveness! In this short statement the significance of EBM in physical medicine and general rehabilitation will be analysed and discussed.

Keywords

EBM, evidence based medicine, physical medicine, physiotherapy, rehabilitation

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Submitted: 2014-04-17 11:26:05
Published: 2014-06-06 08:41:35
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Copyright (c) 2014 Helmut Kern, Stefan Loefler, Veronika Fialka-Moser, Tatjana Paternostro-Sluga, Richard Crevenna, Samantha Burggraf, Hannah Fruhmann, Christian Hofer, Claudia Burmester, Benjamin Süsoy, Eva-Maria Strasser, Markus Praschak, Wolfgang Grestenberger, Friedrich Hartl, Gerold Ebenbichler, Günther Wiesinger, Thomas Bochdansky, Christian Wiederer, Michael Quittan

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