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The Connection Between Evidence-Based Medicine and Shared Decision Making

Tammy C. Hoffmann, PhD1,2; Victor M. Montori, MD, MSc3; Chris Del Mar, MD, FRACGP1
[+] Author Affiliations
1Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
2University of Queensland, Brisbane, Australia
3Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota
JAMA. 2014;312(13):1295-1296. doi:10.1001/jama.2014.10186.
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This Viewpoint considers the interdependence of evidence-based medicine and shared decision making.

Evidence-based medicine (EBM) and shared decision making (SDM) are both essential to quality health care, yet the interdependence between these 2 approaches is not generally appreciated. Evidence-based medicine should begin and end with the patient: after finding and appraising the evidence and integrating its inferences with their expertise, clinicians attempt a decision that reflects their patient’s values and circumstances. Incorporating patient values, preferences, and circumstances is probably the most difficult and poorly mapped step—yet it receives the least attention.1 This has led to a common criticism that EBM ignores patients’ values and preferences—explicitly not its intention.2

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The Interdependence of Evidence-Based Medicine and Shared Decision Making and the Need for Both as Part of Optimal Care
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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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