Author - Dr. Aditi Nanda
"What can be asserted without evidence, can also be dismissed without evidence"
Evidence is a fact or information that gives firm conviction of a belief or proposition. Decision established over evidence become firm stepping stones to produce highly efficient outcomes.
A walk through the history- In the year 1972, Sir Archibald Leman Cochrane laid the foundation of evidence-based practice. He was a strong supporter of "randomised controlled trials" and promoted them as a way to get the most verified form of evidence.
Why do we need evidence? - Solid evidence surfaces the associated risks, which can be alleviated by planned actions. It cuts down the cost and demand of resources required for execution of a policy, plan or procedure.
What do the stats say? - The overall impact of evidence-based decision-making has been huge. The global death rate has stricken down to 7 in 2019 from 13 in 1970, per 1000 population. With most of the diseases being detected early, we today have far lesser number of complications and thereby, reduced morbidity and mortality rates than we had five decades back.
Role of technology- It has led our way to the most relevant information in the shortest possible time. We have also come a long way on the graph of sophistication of diagnostics, from merely observing eyes and ears, to tasting urine, to microscopy, to the present-day molecular testing. We have modalities like Regenerative medicine, Positron emission tomography (PET) scan, Immune modulations, Genetic engineering, Cell therapies, 3D- Bioprinting, Nano therapy, Robotics etc. firmly holding the pillars of modern-day medicine.
The world of Vaccines- an obligation of evidence-based approach-
Smallpox- It was Sir Edward Jenner who first noticed that the people who once had cowpox never caught smallpox. He systematically tested his observation to get firm evidence, to be able to use cowpox infection as a preventive measure.
Covid- 19- The development of Covid-19 vaccine in less than a year was nothing, but a scientific marvel. Randomised Controlled Trials – the source of the most reliable evidence, have had an enormous role in bringing the vaccine into action.
Malaria- The World Health Organization has, for the first time approved a malaria vaccine for use in children. We now have ‘Evidence’ meeting the WHO standards. The vaccine named ‘Mosquirix’ will provide immunity against P.falciparum, the most lethal of malarial parasites.
Where do we still lack? -As is famously said, eyes only see what the mind knows. The mere availability of evidence is not sufficient. Half-baked knowledge does equal harm as no perception at all. One requires keen observation, and analytical clarification of the served information before putting it to operation.
A torch into the future- In the words of Carl Sagan (an American astronomer), “The absence of evidence is not the evidence of absence”. We have achieved what once seemed impossible, but there are many more doors to open. And remember- “sky is the limit”.
