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Evidence-based public health, community medicine, preventive care

by M Jenicek, S Stachenko
Med Sci Monit ()

Abstract

The use of eveidence-bsed reasoning and decision-making theory and practice is becoming increasingly commonplace in most of the halth sciences. Public health, which encompasses health protection, disease prevention and health promotion, has traditionally been more evidence-based than clinical medicine. However, more must be done to grade evidence in the abasence of classical clinical trials or other experimental proof. Decisions in public health also rely on economical, social and political considerations, but how can evidence in these fields be graded forthe best possible decision-making in public health? Moreover, evidence is often unequally distributed in realtion to different focus groups. For example, evidence in the area of women's health should be as extensive as it is in the area of men's health.\n\nMedicine has traditionally been more ethically inclined than many other fields of human endeavour. In light of this, should we require all decision makers involved in health policies (i.e. politicians, economists, and other stakeholders) to be equally ethically minded? Decisions made without using the best evidence in setting the priorities of health programs and health policies may be ethically questionable. However, the buredn and responsibility no longer lie exclusively on the shoulders of physicians and nurses.\n\nEvidence-based problem solving anddecision-making in health sciences are only approximately a decade old. As a result, the already impressive, but still incomplete accomplishments of the evidence-based medical world require further advancements.

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