How has evidence-based medicine influenced modern day healthcare?
In part 3, we look at how evidence-based medicine has evolved over time and below are just some of the examples of how previously established medical practices have changed due to new evidence.
If you haven't already, take a read of part 1 and part 2.
Treating blood pressure
- Old practice: Doctors used to think that high blood pressure was a 'normal' part of getting old and that the benefits of treating this was unclear in the very elderly.
- New practice: Studies (such as the SHEP/HYVET and later SPRINT/SPRINT-Senior trials) have led to a re-evaluation of blood pressure targets and has demonstrated good evidence to support treating high blood pressure in the elderly also.
Use of Aspirin as a preventative medicine
- Old practice: Aspirin was commonly recommended to the general population to take in order to prevent a serious cardiovascular event e.g. a heart attack.
- New practice: New evidence suggests that the benefits of aspirin in preventing first-time heart attacks and strokes should be carefully weighed against the risk of bleeding. Guidelines now recommend a more individualised approach.
Use of Diclofenac as a painkiller
- Old practice: Diclofenac, a common pain reliever and anti-inflammatory drug, was often prescribed for various types of pain and inflammation, such as arthritis or injuries.
- New practice: Relatively recent evidence has shown that long-term use of diclofenac, especially in high doses, can be associated with an increased risk of heart problems. Doctors are now more cautious about prescribing it for extended periods, particularly for individuals with cardiovascular risk factors.
Dietary recommendations for cholesterol
- Old practice: There was an emphasis on restricting dietary cholesterol intake to lower blood cholesterol levels.
- New practice: Current evidence suggests that dietary cholesterol intake for most people has less impact on blood cholesterol levels than previously thought. Guidelines have shifted focus to our overall dietary patterns, emphasising the importance rather of reducing saturated and trans-fats in our diets.
Prostate-Specific Antigen (PSA) testing
- Old practice: Men often had routine PSA tests (blood testing) to check for prostate cancer.
- New practice: Due to concerns about over-diagnosis and unnecessary over-treatment, guidelines now recommend shared decision-making between patients and their healthcare providers before undergoing PSA testing.
Introducing allergenic foods to babies
- Old practice: Parents used to wait before giving their babies foods like peanuts to avoid allergies.
- New practice: Research (such as LEAP and EAT studies) suggests that introducing these foods early might actually help prevent allergies.
These are just some of the examples highlighting the dynamic nature of medical practice as it adapts to the evolving landscape of scientific evidence.
As part of evidence-based medicine, medical professionals regularly reassess and update guidelines based on the most current research findings to ensure the best possible care for patients.
