Dr. Aseem Malhotra

It's constantly evolving.

We were also taught at medical school by the founding father of the evidence-based medicine movement, half of what you learn

will turn out to be either outdated or dead wrong within five years of your graduation.

And we can't tell you which half.

You can't tell you which half.

So you have to learn to learn on your own, right?

But how many doctors have got the time or the skill to try and cut through, you know, all the stuff that they're getting through medical journals, looking at independent evidence, and then, you know, being able to try and get to something that,

in a level of information that they can utilize for really benefiting when helping their patients so it comes down to informed consent and for me one thing that you know i think it was mark twain that said that truth often lies in simplicity and the most elegant analytical framework we have

for teaching and practicing medicine is called the evidence-based medicine triad right published in the bmj in 1996 i love this it's beautiful i put it up in my talks it's one of the first slides and i say listen this is the most important side of my talk if you get this you can probably not not only understand why our health is going the wrong direction but you can probably explain most problems in the world as well right so what does that mean okay in the middle of the of the triad our role as healthcare practitioners as doctors is to improve patient outcomes manage risks

Treat illness, relieve suffering.

How do we do that?

There are three inputs.

Our clinical experience, our knowledge, our intuition as doctors over many, many years.

The best available evidence on a drug, on a lifestyle, on a surgical intervention, on ordering a test.

And last but not least, David Sackett said...

taking it into consideration individual patient preferences and values, right?

That's where the informed consent comes in.

So what's the problem?

What are the limitations?

Why have we not really advanced evidence-based medicine?