Harnessing experience: exploring the gap between evidence-based medicine and clinical practice

Area of Science:

• Medical Practice and Clinical Decision-Making
• Health Services Research

Background:

• A recognized disparity exists between Evidence-based Medicine (EBM) and current physician practices.
• EBM often utilizes averaged global data, which may not align with local patient populations and circumstances.
• Local, real-world evidence is crucial for timely and relevant clinical decision-making.

Purpose of the Study:

• To explore physicians' perspectives on integrating clinical experience with EBM.
• To evaluate the potential of Evidence Farming (EF) in generating locally relevant evidence.
• To understand how physicians utilize various information sources in clinical decision-making.

Main Methods:

• A pilot study involving 29 individual interviews and three focus groups (n=10) with physicians.
• Exploration of physicians' current information-seeking behaviors and decision-making processes.
• Assessment of physicians' views on the concept and utility of Evidence Farming (EF).

Main Results:

• Physicians acknowledge the EBM-to-practice gap and frequently rely on clinical experience, colleague opinions, and electronic resources over direct EBM literature.
• Physicians' confidence in clinical experience grows with time, but systematic tracking of this experience is rare.
• The majority of physicians perceive Evidence Farming (EF) as a valuable tool for making scientific evidence more applicable to their practice.

Conclusions:

• Clinical experience, though vital, is underutilized within the EBM framework.
• Systematically collecting clinical experience through methods like Evidence Farming (EF) can address the limitations of current EBM approaches.
• EF has the potential to bridge the gap between EBM and practical clinical application by incorporating real-world physician insights.