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Institute of Medicine (US). Evidence-Based Medicine and the Changing Nature of Healthcare: 2007 IOM Annual Meeting Summary. Washington (DC): National Academies Press (US); 2008.

Cover of Evidence-Based Medicine and the Changing Nature of Healthcare

Evidence-Based Medicine and the Changing Nature of Healthcare: 2007 IOM Annual Meeting Summary.

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Foreword

Evidence-based medicine (EBM) has been famously characterized by David Sackett as the “conscientious, explicit, and judicious use of current best evidence in making decisions about individual care.” The central notion in EBM of the importance of integrating individual clinical expertise with the best available external evidence provides a helpful framework for providers navigating the uncertainty inherent in patient care. The selection of EBM as a topic for the 2007 Annual Meeting of the Institute of Medicine (IOM) signals its potential as a key driver toward greater value and efficiency in medical care. Technological and scientific innovations continue to expand the universe of medical interventions, treatments, and approaches to care, ushering in an era rich with potential for improving the quality of health care but also rife with increased uncertainty about what works best for whom. That uncertainty can—and does—lead to the delivery of services that may be unnecessary, unproven, and sometimes harmful.

This publication, Evidence-Based Medicine and the Changing Nature of Health Care, documents the content of the 2007 IOM Annual Meeting. In the years ahead, demographic, epidemiologic, and technologic developments will foist change on health care. Reforms will be necessary to remedy existing shortfalls in access to care as well as to take better advantage of the opportunities provided by innovation, information technology, and broader stakeholder engagement.

At this time in our nation’s history, a host of health policy issues dominate the headlines, from the safety of imported drugs to children’s healthcare coverage. Amid the cacophony surrounding each debate, the IOM strives to voice objective, independent, evidence-based counsel and recommendations on critical questions. We know from experience that ascendancy and importance of healthcare access, cost, and quality challenges are no guarantees of action. The IOM’s mission is to draw attention to issues and options that lay the groundwork for policy. We work to engage the field, facilitate needed discussion and debate, and develop sound policy recommendations.

The last 2 years have seen a burgeoning interest in convening activities at the IOM: the forums and roundtables that bring together individuals from government, academia, business, and the public at large for collective consideration and action around common problems. The Roundtable on Evidence-Based Medicine draws upon the many perspectives within the healthcare field, informs the debate, and provides an opportunity for dialogue among key stakeholders. The Roundtable’s overview publication, The Learning Healthcare System, outlines a number of opportunities to transform the development and use of evidence to improve health care. The subsequent workshops and meetings in the Learning Healthcare System series delineate research methods, assess data availability, and describe ways to improve research on the effectiveness of healthcare delivery. The 2007 IOM Annual Meeting drew upon the Roundtable membership for planning and execution and builds upon some of the work of the Roundtable. This publication is the second in the Learning Healthcare System series.

I would like to offer my personal thanks to Roundtable participants, particularly Mark McClellan, Betsy Nabel, and Michael McGinnis, for their contributions as part of the planning committee.

Harvey V. Fineberg, M.D., Ph.D.

President, Institute of Medicine

Copyright © 2008, National Academy of Sciences.
Bookshelf ID: NBK52823
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