Experts recommend evidence-based medicine for care of veterans

There is no doubt that military veterans deserve only the best quality of care in healthcare. This is true not just for their physical wounds – broken bones, concussions, amputated limbs and so on – but for their psychological ones, as well.

Still, it is not always clear what the best care means for patients. In a recent report compiled by the Institute of Medicine, experts suggested that military veterans who served in Iraq and Afghanistan may benefit from evidence-based medicine, which is one of the most prominent ongoing and future trends in healthcare.

Technology will help drive evidence-based medicine
A review published by the International Journal of Public Policy noted that, in 2007, the U.S. ranked below five other developed nations in several measures of healthcare quality. The authors of the review suggested that this may be partly a consequence of standard practices of medicine – prescribing well-worn treatments, consulting local experts and so on. They argued that it would be far more efficient and effective for doctors to turn to evidence-based medicine.

This platform of care, which relies on medical and scientific literature to make clinical decisions , is likely to become more robust in the future as electronic health record systems are more widely adopted. This trend would allow for the collection and analysis of a wealth of patient data, which is an important facet of evidence-based medicine.

IOM recommends greater use of evidence-based care
About 44 percent of veterans coming back from Iraq and Afghanistan report having some sort of medical difficulties. These include traumatic brain injuries, post-traumatic stress disorder, depression and substance abuse.

However, the IOM noted that the medical treatment they receive may be a bit lacking.

"In many ways, the [Departments of Defense and Veterans Affairs] are at the forefront of providing evidence-based care for service members with TBI and psychological health problems. But challenges exist in both systems," the review authors wrote. "Not all service members and veterans who need treatment receive it. Recent increases in hiring may help to alleviate a shortage of clinicians; however, unrealized opportunities remain in improving clinician training and evaluation. When care departs from the scientific evidence base and varies significantly from clinician to clinician, patients may receive poor quality care."

For example, there is ample scientific evidence that restricting access to firearms may help reduce suicide, but government policies will not allow this for service members’ privately owned weapons – even when they are at risk of suicide.

The IOM recommended that the DoD and VA align their treatments with the scientific literature before making them national, and ensure that their clinicians are trained to rely on this base of evidence.

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