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Nephrology Dialysis Transplantation, Vol 14, Issue 90003 46-52, Copyright © 1999 by Oxford University Press

ORIGINAL ARTICLES

Evidence-based medicine and its horizons: a useful tool for nephrologists?

A Liberati, E Telaro and A Perna
Italian Cochrane Centre and Laboratory of Health Services Research, 'Mario Negri' Institute, Milan, Italy; Centro di Ricerche Cliniche Aldo e Cele Daccò, 'Mario Negri' Institute, Villa Camozzi, Bergamo, Italy; Cattedra di Statistica Medica E Biometria, Universitá Degu Studi, Modena, Italy; Corresponding author at: Italian Cochrane Centre and Laboratory of Health Services Research, 'Mario Negri' Institute, via Eritrea 62, 2015 Milan, Italy

Though the concept of 'evidence-based medicine' (EBM) nowadays has become very popular and even fashionable, its practice is far from being an established reality. There are many reasons why, despite its potential, EBM finds obstacles in expressing its full potential as a tool to better inform health care decisions. Broadly speaking, these obstacles fall into three categories: (i) inadequacy of available information with respect the complexities of health care delivery; (ii) poor quality of clinical research; and (iii) insufficient and inappropriate efforts to promote the uptake of effective interventions in clinical practice. In the first part of the paper, we will discuss: (i) what evidence-based medicine is: (ii) why systematic reviews are the fundamental tool of EBM and what is really special about them; (iii) what are the tools for the practice of EBM; (iv) what its limitations are; and (v) what are the hindrances to its implementation. In the second part, a brief assessment of the state of the art of systematic reviews in nephrology will be presented, with special reference to the activities of the recently launched Cochrane Collaborative Review Group in Renal Diseases.
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