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Re: How do you treat lat. epicondylitis
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Re: How do you treat lat. epicondylitis - January 23, 2006 8:32:00 PM
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Randy Dixon
Posts: 744
Joined: August 6, 2004
Status: offline
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Jason,
We always seem to agree on everything but terms. the use of EBM reminds me of many discussions I have had on other forums regarding the use of the term agnostic. Many people when asked about their religious beliefs, if they are theist or atheist, will answer "I'm agnostic", as if this answers the question. It is quite possible, probable even, to be either an agnostic theist or an agnostic atheist, therefore the term, as used is meaningless. They usually intend it to mean as "I don't know" or "I'm spiritual but not religious" or "I have my own beliefs about God", but this is not it's meaning, it is used because a different term is needed but not available. Of course, it can be argued that with the common usage of the term, that it has a NEW definition. I think EBP is similar. The definitions one hears used today are hardly controversial or evidence of a paradigm shift. Here is an excerpt from an article post by Jon Newman long ago:
In the Background section, we mentioned a number of criticisms that have been raised against EBM. With such critics, we have the beginnings of an intelligible debate, for we have several reasonably distinct approaches to intervention questions, and we can ask substantive questions about the strengths and weaknesses of each, and we can ask which should be used when or how they should be combined. The present point is simply this: there is a tendency for some proponents of EBM to duck these questions and avoid this debate by defining "evidence-based medicine" such that it includes the best possible combination of basic science, clinical experience, and clinical trials. In so doing, the proponents of EBM come awfully close to simply defining EBM as the best way to practice medicine, whatever that may be. In other words, they respond to the second order conceptual question ("what is EBM?") by saying that EBM is whatever approach to medicine best answers the first order normative question ("how ought we to practice medicine?"). The proponents of EBM thereby give the illusion of having answered both sets of questions when in fact they have answered neither. They thus walk away from an important and substantive debate.
http://www.biomedcentral.com/1472-6963/3/14
So like "agnostic" perhaps the way "EBP/EBM" is widely used has become the definition of the philosophy but perhaps another term would better serve this purpose and let the original stand.
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Re: How do you treat lat. epicondylitis - January 24, 2006 6:28:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
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Randy-
As usual, i see where you're coming from. I think your "agnostic" example is very instructive also.
Just as there are people misusing that term, there are those that misuse the term EBM or recast it into some strict, exclusive paradigm of care. When I use the term, I am referring to Sackett's orginal definition, which of course has flexibility, provider experience and patient values as central tenets.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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