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Evidence-based practice and practice-based evidence

Nature Clinical Practice Rheumatology volume 2, pages 114–115 (2006)Cite this article

EVIDENCE-BASED MEDICINE has been described as “derived from many sources beyond randomized clinical trials”.1 The term 'evidence-based medicine' is, however, applied almost exclusively to data from clinical trials. The allure of 'evidence-based medicine' has led many clinicians at this time to regard data from randomized clinical trials as the only valid source for all clinical knowledge.

The randomized, controlled clinical trial is the best method, the 'gold standard', to evaluate any new therapy compared to a placebo or control therapy. Clinical trial results certainly should be applied as evidence-based practice in standard clinical care. Advances in chronic rheumatic diseases, however, have resulted as much from PRACTICE-BASED EVIDENCE, as from randomized, controlled trials. Practice-based evidence is defined here as information regarding diagnosis, prognosis, management strategies, medications, toxicities, and outcomes in standard clinical care according to quantitative measurement and analyses of data rather than according to qualitative impressions.

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Author notes

  1. T Pincus is Professor of Medicine and Microbiology, and T Sokka is Research Assistant Professor

Authors and Affiliations

  1. the Vanderbilt University Medical Center in Nashville, TN, USA

    Theodore Pincus & Tuulikki Sokka

  2. Consultant Rheumatologist at the Jyväskylä Central Hospital in Jyväskylä, Finland

    Tuulikki Sokka

Authors
  1. Theodore Pincus
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  2. Tuulikki Sokka
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Correspondence to Theodore Pincus.

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The authors declare no competing financial interests.

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Pincus, T., Sokka, T. Evidence-based practice and practice-based evidence. Nat Rev Rheumatol 2, 114–115 (2006). https://doi.org/10.1038/ncprheum0131

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