Present and future of Evidence-Based Medicine in clinical veterinary medicine – What we have learned and ideas on where we need to go

During the last decade, evidence-based medicine (EBM) advocates have focused on promoting the concepts and ideals of EBM as well as teaching the skills needed to use it efficiently and effectively. Despite this emphasis on education, a significant number of perceived barriers preventing clinician-led implementation have developed. Remember, at its core EBM attempts to apply population studies to individual patients. This is in stark contrast to traditional medical proactive in which clinical experience (often from an individual patient) is commonly used to define and defend the treatment of entire groups with similar problems. Thus, it is apparent that promoting this paradigm shift should emphasize the fact that these data must be combined with clinical experience. When clinicians read and think about evidence-based medicine (EMB), thoughts that often come to mind are “how does this really affect me and if I want to use EBM?” and “How I can do this in my daily practice?” It is important to remember the evidence or data by itself does not make a decision for you- but it can help support the patient care process. We must now focus on encouraging collaboration and shared learning across career stages to overcome these barriers. Recent studies suggest that these proactive steps can facilitate the uptake of EBM and reduce cognitive and affective biases in clinical decision-making. Therefore, we need to look critically at all the pros and cons of EBM and move forward, not as evangelical preachers or high minded academics, but as colleagues and mentors working to improve the use of all available data when treating our patients. As clinical trial data increases, we must continue to educate individuals on the benefit of EBM when used judiciously and correctly.