"Evidence-based medicine" means just what it says - treatments that have been shown in scientific studies to work. But studies are one thing - do these treatments work as well in real-world clinics and hospitals? A new study in Sweden found that they do.
Researchers at Karolinska Hospital in Stockholm analyzed a government registry of more than 60,000 patients with a particular type of very serious heart attack called ST-elevation myocardial infarction. These patients were treated between 1996 and 2007, a time of increasing sophistication in caring for heart attack victims.
Lead author Tomas Jernberg says studies began showing benefit from simple things like taking aspirin to advanced, high-tech therapies like bypass surgery.
"During the last two decades we have seen that several new treatment strategies have been proven to lower mortality and morbidity," he says. "And in this study, we wanted to examine the effects of these efforts on the given treatment and survival in the clinical reality."
So did all these new evidence-based strategies work?
Jernberg says the answer became clear as hospitals gradually adopted proven therapies.
"And we can also see that this increased use of evidence- or guideline-recommended treatment is associated with a substantial lower mortality."
One measure of mortality is the 30-day death rate, the percentage of patients who died in the first month after having these very serious heart attacks.
"The 30-day mortality has more than halved, so it's a decrease in mortality," Jernberg says.
Although use of the various evidence-based treatments increased over the 12-year span in this study, it never reached 100 percent because not all treatments are appropriate for every patient's individual situation.
There was also a lot of variation in the speed at which hospitals began using many of the newer therapies, and the authors suggest that adopting evidenced-based treatments faster could help improve patient outcomes sooner.
The study by Karolinska Hospital researcher Tomas Jernberg and colleagues is published in the journal of the American Medical Association, JAMA.