We need to remember that RCTs are not the only component of EBM. 


"Initially, evidence-based medicine focused mainly on determining the best research evidence relevant to a clinical problem or decision and applying that evidence to resolve the issue. This early formulation de-emphasised traditional determinants of clinical decisions, including physiological rationale and individual clinical experience. Subsequent versions of evidence-based decision making have emphasised that research evidence alone is not an adequate guide to action. Rather, clinicians must apply their expertise to assess the patient's problem and must also incorporate the research evidence and the patient's preferences or values before making a management recommendation (figure 1).2"




http://ebm.bmj.com/content/7/2/36.full




"Clinical experience is relatively neglected by the EBM movement, but if that experience were systematically gathered through an approach such as EF, it would meet a need left unfulfilled by EBM."

http://www.ncbi.nlm.nih.gov/pubmed/19018899


Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC




Date:    Mon, 23 Jun 2014 08:12:55 -0400
From:    Michelle Stulberger <[log in to unmask]>
Subject: Herbals, etc.

Good morning!

I am an IBCLC candidate getting ready for the exam this year.  All of the
discussion on LACTNET has been very helpful to me.

One area I have a lot of confusion in surrounds our recent discussion
regarding herbal medicine, galactagogues, etc.  My understanding is that
the ABM does not recommend usage of things like fenugreek and Mother's Milk
Tea.  How does recommending these items conflict with our charge to
practice evidence-based medicine?

Thanks so much for your input!

Michelle in Maryland.



 


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