Evidence-based medicine targets the individual patient, part 1: how clinicians can use study results to determine optimal individual care

Abstract

Despite increasing acknowledgement of its importance,1 some continue to characterise evidence-based medicine (EBM) as focusing on groups of patients and neglecting the individual.2 3 In this 2-part commentary, we will describe EBM tools that address individual patient decision-making. In this first part we will focus on guides for applying research evidence and for determining the benefit to risk ratio in individual patients. EBM assists clinicians pondering the generalisability of RCT results to their individual patients, and their individual circumstances (table 1).4-6 That guidance directs clinicians to look for possible differences in biological factors, socioeconomic characteristics, and attitudinal or behavioural characteristics of individual patients that might modulate treatment effects.7 For instance, antibiotics for otitis media seem to be most beneficial in children younger than 2 years of age with bilateral acute otitis media, and in children with both acute otitis media and otorrhoea. …