What is evidence-based medicine and what questions should a patient ask a doctor - expert answer

Evidence-based medicine is a concept that is heard more and more often today. But what does it mean in practice, especially in oncology, where the cost of an error is highest? UNN spoke about this with Yuriy Babinets, director of the "MedGuard" company, which provides medical support to patients.

What stands behind the term "evidence-based medicine"

"Evidence-based medicine is a modern approach to treatment, where medical decisions are made not on the basis of 'the way it's usually done' or a doctor's personal opinion, but on the basis of international scientific research, clinical recommendations, and the proven effectiveness of treatment methods," explains Babinets.

He emphasizes that evidence-based medicine is not just "dry protocols," but a combination of three key factors: scientifically confirmed data, the doctor's practical experience, and the individual characteristics of the patient.

In practice, according to Babinets, this means that the patient is not prescribed unnecessary examinations or "fashionable treatments without evidence," but rather those methods whose effectiveness and safety are actually confirmed.

"This is especially important in complex fields — oncology, cardiology, surgery, intensive care — where the cost of an error is very high," the specialist emphasizes.

Evidence-based medicine in oncology

In oncology, evidence-based medicine is of critical importance because it is here that the correctness of the patient's journey directly affects the duration and quality of the patient's life.

As Babinets explains, the key principles here are:

• accurate and modern diagnostics;
• treatment according to international standards and national protocols;
• a multidisciplinary approach;
• personalization of treatment;
• control of all stages of treatment and rehabilitation.

"Today, high-quality oncology is not the decision of a single doctor. It is teamwork: an oncosurgeon, a chemotherapy specialist, a radiologist, a pathologist, an anesthesiologist, a rehabilitation specialist, and other experts," explains the director of "MedGuard."

That is why the following are so important:

• international treatment standards;
• oncological consultations (tumor boards);
• a "second opinion";
• monitoring of post-operative support;
• proper coordination between specialists.

What a patient should pay attention to and what questions to ask a doctor  

A patient who wants to be treated by an "evidence-based" doctor should pay attention to the specialist's practical skills and work style.

According to Babinets, a doctor who works according to the principles of evidence-based medicine explains their decisions in clear language and argues why they recommend this specific treatment. Such a doctor does not promise a "100% result" and does not prescribe dozens of unnecessary drugs "just in case."

"They rely on the results of randomized controlled trials (RCTs) and meta-analyses, as well as modern international recommendations. They are open to a 'second opinion' and are not afraid of consultations with colleagues," says Babinets.

The patient has the right to ask the doctor simple and absolutely normal questions:

• why do you recommend this specific treatment method?
• does this comply with international recommendations?
• what are the alternatives?
• what are the risks and the expected result?
• is a consultation with related specialists necessary?
• does it make sense to get a "second opinion"?

The specialist emphasizes that it is important to pay attention not only to the doctor but also to the clinic itself, in particular, whether it operates according to modern international standards and national protocols. Also, whether there is a multidisciplinary approach and whether post-operative support is provided. The clinic should have a treatment quality control system. It is very important how openly and honestly the clinic communicates with the patient.

Babinets explains that in their practice of patient support, the company pays attention not only to the status or popularity of a doctor, but to their real clinical experience, reputation in the professional community, treatment results, ability to work in a team, and communication with the patient. Important factors also include working according to modern international standards and national protocols, as well as a readiness to manage the patient systematically, rather than "from consultation to consultation."

Babinets emphasizes that it is important for the patient not to be left alone with a difficult diagnosis.