Does following Evidence-Based Medicine (EBM) guidelines to direct clinical care really improve outcomes? A recent study published in the Journal of Evidence-Based Medicine by Dell Medical School faculty member Ed Bernacki, MD, indicates it can.
Bernacki and his co-authors from Accident Fund Holdings Corporation analyzed 45,951 worker’s compensation lost-time claims filed in Michigan between 2008 and 2013. After adjusting for medical complexity, type of accident, age, gender and other factors, they found that physicians who provided care according to EBM guidelines had better outcomes.
Injured workers in the high-EBM-compliance group experienced 13 percent fewer lost-time days and incurred 37.9 percent less medical care expense than the lower EBM-compliance group. As the medical complexity of the condition increased, the differences were even greater. In the group with the greatest degree of medical complexity, the difference in time off work in the high-compliance group was 18 percent less and medical costs 38 percent less than in the low-compliance group.
More importantly, the study demonstrated a steady increase in the number of inappropriate procedures performed per injured worker in the lower-compliance group — an increase seen across all medical complexities.
“This study indicates that using guidelines not only insures consistency among medical providers but improves outcomes,” Bernacki said. “Unfortunately, studies like this measuring the efficacy of EBM are rare in the medical literature. More need to be done to validate that better medical care can have positive outcomes.”