Evidence based medicine in physical medicine and rehabilitation (English version)


Submitted: 17 April 2014
Accepted: 5 June 2014
Published: 6 June 2014
Abstract Views: 3841
PDF: 835
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Authors

  • Helmut Kern Dept. of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna; Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Stefan Loefler Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Veronika Fialka-Moser University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria.
  • Tatjana Paternostro-Sluga University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria.
  • Richard Crevenna University Clinic of Physical Medicine, Medical University of Vienna; Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna, Austria.
  • Samantha Burggraf Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Hannah Fruhmann Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Christian Hofer Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Claudia Burmester Dept. of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria.
  • Benjamin Süsoy Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
  • Eva-Maria Strasser Dept. of Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Vienna; Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria.
  • Markus Praschak Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria.
  • Wolfgang Grestenberger Fachgruppe Physikal. Medizin, Wiener Ärztekammer, Austria.
  • Friedrich Hartl Bundesfachgruppe Physikal. Medizin, Österreichische Ärztekammer, Austria.
  • Gerold Ebenbichler University Clinic of Physical Medicine, Medical University of Vienna; Berufsverband der Österreichischen Fachärzte für Physikal. Medizin und Rehabilitation (BÖPMR), Vienna, Austria.
  • Günther Wiesinger University Clinic of Physical Medicine, Medical University of Vienna, Austria.
  • Thomas Bochdansky Reha-Klinik Montafon, Schruns, Austria.
  • Christian Wiederer Kurhaus Bad Gleichenberg, Bad Gleichenberg, Austria.
  • Michael Quittan Austrian Society for Physical Medicine & Rehabilitation (ÖGPMR), Vienna; Dept. of Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Vienna; Karl Landsteiner Institut für Remobilisation und funktionale Gesundheit, Vienna, Austria.
In the last twenty years the term “Evidence Based Medicine (EBM)” has spread into all areas of medicine and is often used for decision-making in the medical and public health sector. It is also used to verify the significance and/or the effectiveness of different therapies. The definition of EBM is to use the physician’s individual expertise, the patient’s needs and the best external evidence for each individual patient. Today, however, the term EBM is often wrongly used as a synonym for best “external evidence”. This leads not only to a misuse of evidence based medicine but suggests a fundamental misunderstanding of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions, public healthcare providers and politicians use external evidence alone as a main guideline for financing therapies in physical medicine and general rehabilitation without taking into account the physician’s expertise and the patient’s needs.The wrong interpretation of EBM can lead to the following problems: well established clinical therapies are either questioned or not granted and are therefore withheld from patients (for example physical pain management). Absence of evidence for individual therapy methods does not prove their ineffectiveness! In this short statement the significance of EBM in physical medicine and general rehabilitation will be analysed and discussed.

Helmut Kern, Dept. of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna; Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna
head of institutes
Kern, H., Loefler, S., Fialka-Moser, V., Paternostro-Sluga, T., Crevenna, R., Burggraf, S., Fruhmann, H., Hofer, C., Burmester, C., Süsoy, B., Strasser, E.-M., Praschak, M., Grestenberger, W., Hartl, F., Ebenbichler, G., Wiesinger, G., Bochdansky, T., Wiederer, C., & Quittan, M. (2014). Evidence based medicine in physical medicine and rehabilitation (English version). European Journal of Translational Myology, 23(4). https://doi.org/10.4081/ejtm.2013.3824

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