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Clinical Diabetes 20:22-23, 2002
© American Diabetes Association ®, Inc., 2002

Commentary

Evidence-Based Diabetes Care

William H. Herman, MD, MPH

In recent years, we have witnessed an increasing focus on "evidence-based medicine." Indeed, for the first time, the American Diabetes Association (ADA) this year has provided evidence gradings for its position statement on "Standards of Medical Care for Patients With Diabetes Mellitus." This position statement is reprinted in abridged form in this issue (page 24). The entire document can be found in Diabetes Care1 or on the ADA Web site at http://care.diabetesjournals.org/cgi/content/full/25/1/213.

What is evidence-based medicine? What are its strengths and limitations? Does it reflect a passing craze or a true evolution in clinical practice?

Sackett and colleagues defined evidence-based medicine as "the conscientious, explicit, and judicious use of clinically relevant research in making decisions about the care of individual patients."2 The strength of evidence-based medicine is that it moves clinical practice from anecdotal experience and expert opinion to a strong scientific foundation. It integrates clinical medicine with basic and clinical research and thus enhances the effectiveness and safety of diagnostic, preventive, and therapeutic measures.

In general, evidence-based medicine advocates that experimental methods—that is, randomized, controlled clinical trials (RCTs)—provide the gold standard for evaluation and the basis for clinical practice. The strength of RCTs lies in their internal validity. In RCTs, randomization ensures that treatment groups differ only in their exposure to the intervention, and hence, differences in observed . . . [Full Text of this Article]

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Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2002 by the American Diabetes Association.