The practice of evidence-based medicine (EBM) is gaining traction not only in the United States, but also in Asia and Southeast Asia. At the 12th Asia Pacific Evidence-Based Medicine & Nursing Workshop & Conference held on February 18-21, 2014 and hosted by the National University Hospital in Singapore, medical practitioners from all over Asia came together to learn the principles of EBM and evidence-based nursing (EBN), and to develop the skills necessary to both apply and teach EBM and EBN in clinical practice. Moreover, some Southeast Asian countries have established institutions to promote the practice of EBM. The Indonesia Clinical Epidemiology Evidence-Based Medicine Network (ICE-EBM) and the Julius Centre University of Malaya (Centre for Clinical Epidemiology and Evidence Based Medicine) in Malaysia are two examples of such organizations. In the Philippines, a group of medical doctors created a syllabus that provides the rationale, recommendations, and resources for practicing EBM specifically in developing countries. This publication is unique in that it highlights the particular challenges and obstacles facing poorer nations.
China also supports and promotes EBM. The Chinese Cochrane Center in China established the Journal of Evidence-Based Medicine in 2008, published by Blackwell Publishing Asia Pty Ltd. The journal publishes an English-language version and a Chinese-language version (called the Chinese Journal of Evidence-Based Medicine) and is accessible online. Furthermore, the 7th Asia Pacific Conference on Evidence-Based Medicine in China, held in August 2012 at the First Teaching Hospital of Xinjiang Medical University in Urumqi, brought together EBM experts, leaders, and junior researchers to discuss and promote EBM. The theme of the conference was “EBM: discipline, platform, cooperation, change, results.”
Taiwan, too, has embraced EBM by establishing in 2007 the Center for Evidence-Based Medicine at Taipei Medical University. Related to EBM is the growing interest in Taiwan in the use of health technology assessments (HTAs) to inform healthcare delivery. After studying HTA agencies in Australia, Canada, and the UK, Taiwan’s Ministry of Health and Welfare established the National Institute of Health Technology Assessment (NIHTA), an independent medical nonprofit organization that conducts HTAs not influenced by governmental agencies and manufacturers. An article by the Taiwan Minister of Health and Welfare, Dr. Wen-Ta Chiu, published in Eureporter Magazine on May 16, 2014 (http://www.eureporter.co/magazine/2014/05/16/affordable-health-technology-assessment-in-taiwan-a-model-for-middle-income-countries/), describes this HTA model and its successes to date. Taiwan is also hosting the 3rd International Society of Evidence-Based Healthcare Conference in November 6-9, 2014.
The question is have these efforts changed the way clinicians practice medicine in Asia? The results of 1 study conducted in regional hospitals in Taiwan showed various levels of implementation of EBM among healthcare professionals. A second study conducted in Japan found positive attitudes among physicians toward EBM but multiple barriers to its application.
Obviously, there is much more education needed before EBM is universally accepted and implemented in clinical practice. Efforts such as those described here are good first steps. We need to continue to develop initiatives that promote awareness among healthcare professionals around the world of the need to use scientific evidence as the foundation for practicing medicine, informing healthcare policies, and making informed decisions about product performance, efficacy, safety, and impact on clinical outcomes.