Understanding why we agree on the evidence but disagree on the medicine

Abstract

Despite the fact that physicians, nurses, and respiratory therapists share a common training in scientific evidence and frequently share a common understanding of the evidence, debates occur about the proper management of individual patients. Clinicians may interpret this as a failure of evidence-based medicine, when, in fact, evidence is only one of many factors that play a role in clinical decision-making. By clearly understanding the other factors that affect clinical decision making-prior beliefs about treatment effectiveness, patient and clinician values, and clinical expertise-clinicians can better understand which clinical disagreements are about scientific evidence and which are about other factors.