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

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Helmut Kern *
Stefan Loefler
Veronika Fialka-Moser
Tatjana Paternostro-Sluga
Richard Crevenna
Samantha Burggraf
Hannah Fruhmann
Christian Hofer
Claudia Burmester
Eva-Maria Strasser
Markus Praschak
Wolfgang Grestenberger
Friedrich Hartl
Gerold Ebenbichler
Günther Wiesinger
Thomas Bochdansky
Christian Wiederer
Michael Quittan
(*) Corresponding Author:
Helmut Kern | wil.pys.kern-forschung@wienkav.at

Abstract

In the last twenty years the term “Evidence Based Medicine (EBM)” has been increasingly applied in 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 original definition of EBM rests on the following three pillars: the physician’s individual expertise, the patient’s needs and the best external evidence. Today, however, the term EBM is often wrongly used as a synonym for best external evidence, without taking into consideration the other two pillars of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions and politicians use external evidence alone as the main guideline for financing therapies and therapy guidelines 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). An 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.

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