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[Revival of evidence-based medicine in gastroenterology.]
Maurizio Koch1, Lucio Capurso1
1Senior Directors, Unità Complessa di Gastroenterologia ed Epatologia, Ospedale San Filippo Neri, Roma.
Abstract:
The evidence-based medicine (EBM) in gastroenterology is born with the XIII International Congress of Gastroenterology, the world congress of Gastroenterology, held in Rome in 1988. A clinical epidemiology manual was placed in the congress bag for each participant. The book contained an approach to biostatistics, interpretation of epidemiological data, clinical trials, meta-analysis and decision analysis. In the pocket appeared for the first time a floppy disk that offered softwares for the analysis of Student's and χ2, for randomization and for meta-analysis. In the following years the clinical epidemiology courses of Torgiano were born, now arriving at the 18th edition. The dedicated EBGH.it portal was also born. The reflections of recent years have suggested 8 theses for the renaissance of EBM in gastroenterology. 1. The patient must return to the center of the EBM. 2. There is an urgent need for more efficient production and implementation of evidences. 3. Researchers in gastroenterology should start studies only in relevant clinical fields where are not yet sufficient answers. 4. The EBM must move towards the evidence on the different effects of an intervention. 5. The relevance of the P-value should be reconsidered. 6. Precision medicine is growing. But EBM can not wait. 7. The best validity test is not the significance but the reproducibility of the data. 8. Data from the real world (real world evidence) can help increase the validity of clinical results.
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