Toward a Patient-Centered, Data-Driven Cardiology

Abstract

Beginning in the 1970s and 1980s, the emergence of randomized clinical trials and studies with large cohorts, associated with the development of the methodology for systematic reviews and meta-analyses, triggered a revolution in the way of thinking and performing healthcare practice.Evidence-based medicine (EBM), defined as the integration of the best research evidence with clinical experience and patient values, 1 has become a new paradigm, orienting medical education and specialized publications.One of the principles of EBM was precisely the primacy of information obtained from randomized clinical trials and meta-analyses, which were placed at the top of an evidence hierarchy, valuing quantitative results more than clinical experience and expert opinion.Indeed, it has always been challenging for EBM to integrate empirical evidence with other types of medical knowledge, such as clinical expertise and pathophysiological rationale, or even with the preferences of individual patients. 2

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