There has been increasing reliance by physicians on “evidence-based medicine”, or EBM. EBM has been defined as the “conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients.” EBM integrates clinical experience and patient values with the best available research information. Often this information is presented in the form of ranking or grading of various approaches or diagnoses, based on how strongly the studies support those decisions.

A recent study by the University of Georgia’s College of Public Health analyzed 721 topics from an online medical reference for primary care doctors and found that only 18% of the clinical recommendations were based on high-quality EBM. In an online medical reference often used by physicians, areas of care that are supported by EBM are graded A, B, or C, depending on the strength and quality of the evidence supporting the issue.

Some areas of medicine, such as pregnancy, cardiovascular, and psychiatry, had higher levels of EBM reliance, while others, such as hematology and rheumatology, had the lowest. Many primary care doctors relied more on their acquired knowledge of the importance of laboratory markers or symptoms, rather than on studies that take into account such factors as morbidity, mortality, quality of life, or symptom reduction. Overall, only 51% of primary care recommendations to patients were based on well-established EBM.

In light of the ready availability of Internet information about EBM recommendations, it is unfortunate that so many primary care health recommendations do not utilize EBM. This is especially true for primary care visits, which account for 53.2% of all physician office visits.