Specialists in internal medicine have a strong research and evidence cultur
e, and there is a large evidence base, particularly for diagnostic tests an
d therapeutics.
Deficiencies in evidence exist in the area of clinical diagnosis, including
the sensitivity, specificity and positive and negative predictive values o
f clinical signs.
The practice of evidence-based medicine (EBM) by internal medicine speciali
sts is hindered by lack of clinical information support systems for ongoing
practice evaluation, benchmarking and improvement.
Many internal medicine practitioners are moving towards the use of clinical
practice guidelines to aid the EBM process.
A greater acceptance of EBM processes, including evaluation and guidelines,
and resolving issues of distrust of bureaucracies, practitioner protection
and consumer privacy, would increase the use of EBM in internal medicine.