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Without a reconceptualisation of ‘evidence base’ evidence-based person-centred healthcare is an oxymoron.

Mette Kjer Kaltoft, Jesper Bo Nielson, Oystein Eiring, Glenn Salkeld, Jack Dowie

Abstract


The call for a renaissance in Evidence-Based Medicine will not result in the delivery of person-centred healthcare. In person-centred healthcare the relative importance of the considerations that matter to the person is elicited and combined, at the point of decision, with the best estimates available on the performance of the available options on those criteria. Prior option evaluations based on average preferences that constitute the conventional 'evidence-base' cannot be part of this process, even if some of the underlying data may be of use. The ethics of transparent person-centred care require the evidence-base to be reconceptualised as the unsynthesised matrix of option performance rates on person-important criteria. Abdicating in the face of the challenges resulting from this reconception is a case of the methodological tail wagging the ethical dog.


Keywords


Evidence-based medicine, patient-centered medicine, personalized medicine, person-centered decision support, person-centered healthcare, Point of Decision (POD), population level option evaluations, preferences, preference-sensitive decisions, values

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References


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DOI: http://dx.doi.org/10.5750/ejpch.v3i4.1025

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