What to do until the POEMs arrive. An endothelial example.

Area of Science:

• Evidence-based medicine
• Clinical decision-making
• Endothelial function

Background:

• The shift towards evidence-based medicine prioritizes patient-oriented evidence that matters (POEMs) over traditional disease-oriented evidence (DOEs).
• A gap exists as POEMs are not yet available for all clinical scenarios in family practice.
• This necessitates alternative strategies when POEMs are insufficient for therapeutic choices.

Purpose of the Study:

• To present a decision-making framework for situations lacking POEMs.
• To illustrate the application of this framework using basic science research on endothelial functioning.

Main Methods:

• The proposed method involves the judicious integration of disease-oriented evidence (DOEs).
• Causal pathways are thoughtfully employed to guide preliminary therapeutic decisions.
• The approach is exemplified through a case study in endothelial science.

Main Results:

• The study demonstrates a viable method for clinical decision-making in the absence of direct patient-oriented evidence.
• Application to endothelial functioning highlights the utility of combining DOEs and causal pathways.
• This approach provides preliminary direction for therapeutic choices.

Conclusions:

• A practical approach is offered for clinicians facing evidence gaps.
• Integrating disease-oriented evidence with causal pathways can inform therapeutic decisions.
• This strategy supports evidence-based practice even when patient-oriented evidence is limited.