Milos Jenicek
McMaster University, Canada
Title: Personalized medicine/patient centered health care and evidence-based medicine: Contradictory or complementary?
Biography
Biography: Milos Jenicek
Abstract
Modern health sciences and practice require both a solid grounding in the scientific method and attention to individuals who must benefit, and rightly so, from the best possible understanding and decision making about individuals and groups of individuals in clinical and community settings. Until now, evidence-based medicine has contributed mainly to the former, especially with regards to dealing with cause-effect relationships between noxious and beneficial factors affecting health as seen through sets of cases. Defining improved clinical expertise, patient values and patient circumstances must be approached with equally structured methodological rigor and practice, reproducible and evaluable in various prevailing settings of care. The current and rapidly developing interest in the attention given to individual patient characteristics, patient environment and type of care is created, developed and increasingly practiced by more than one entity: Patient-centered care, patient-centered medicine, personalized medicine, patient-centered health care. These fields all focus on individuals and very often with few or unique cases, but are they identical? A clinical-epidemiological and biostatistical approach to patient health problem solving is not enough. It must be expanded through qualitative research, case studies, clinical case reporting, broader ways of critical thinking and argumentation as well as through patient care ethics from a modern philosophy perspective in increasingly operational manners, forms, and techniques. Are these patient-focused entities equally well or better defined in their identity, objectives, practices and evaluation as pertains to their content, structure, and impact? Patient-centered care and medicine are complementary to evidence-based medicine. They are the trigger of care as well as the endpoint of evidence-based practice and its end-decision step in individual care. Their equal importance must be emphasized, understood and further justified. And then, what next?