Problems and prospects of using evidence-based medicine in hygiene (systematic review)

Abstract

In the modern world, the principles and methods of Evidence-Based Medicine (EBM)) are the recognised basis for the development of Medicine despite the existing barriers to its implementation. EBM was formed and developed within the framework of its medical direction. In preventive medicine, the adoption of the term EBM was not accompanied by the development of appropriate definitions, standards, methods, and regulatory documents. This article discusses the problems and prospects for the development of EBM in hygienic science and practice. The authors conducted an independent screening of the frequency of publications on Preventive Medicine using the terms and provisions of EBM over the past ten years in the RSCI and MEDLINE (PubMed). The number of publications in English - language sources was found to exceed domestic ones by 45.5-139 times on all issues of EBM. In the RSCI, publications related to EBM in the preventive direction of Medicine accounted for 28 % of the total publications on EBM, in MEDLINE- 45 percentage. The data obtained indicate a more occasional use of the principles of EBM in domestic Medicine, especially in relation to preventive Medicine. Taking into account the experience of EBM in clinical Medicine, the article defines EBM, presents the stages of the EBM methodology, a variant of the hierarchy of evidence, and ideal characteristics of surrogate outcomes for preventive Medicine. For most hygiene problems, systematic reviews and meta-analyses will be the most evidence-based. The use of EBM was indicated to be impossible without understanding the fundamental principles and the correct application of biostatistics. Approaches to the classification, evaluation, development, and examination of clinical practice guidelines based on the principles of EBM, abroad and in Russia, and the possibility of their use for regulatory and methodological documents to ensure sanitary and epidemiological well-being are considered.