Evidence-Based Medicine Applied to Fixed Prosthodontics

People who seek help from professionals have a right to expect that formal measures have been taken to assess the relative merits of the various forms of health care on offer, be these, for example, radical surgery or fixed prosthodontics.1 There is increasingly wide support for the principle of reliable assessment of the effects of health and social interventions on outcomes that matter to the people to whom they are offered. Debate continues, however, about the methods of assessment that should be used in implementing this principle in practice. Different strategies for improving treatment effectiveness and quality have been proposed under different names. “Out-come research”, “technology assessment methodology”, “quality management and as-surance”, “clinical guidelines”, “parameters of care”, “health economy analyses”, etc. are familiar terms. Which strategy is selected and, perhaps more important, funded, is influenced by current beliefs and priorities in society. However, a common denomi-nator of the different strategies is the concern about the appropriateness of care, whether on an individual or on a population level. It is in this context that a new strat-egy for teaching the practice of medicine, named evidence-based medicine (EBM), was introduced in 1991 at the McMaster University in Canada.2 The rationale for changing the teaching strategy was the assumption that although traditional medical training resulted in a more-or-less thorough understanding of basic mechanisms of disease and pathophysiological principles, this combined with common sense and unsystematic observations from one’s own clinical experience did not prepare the physician for assessing and evaluating the new diagnostic tests, treat-chapter 10

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