Evidence-based medicine (EBM) has gained great importance in child healthcare.Yet, the practical process of clinical decision-making is far more complex and ranges from highly sophisticated clinical trials to personal experience of a pediatrician on previously treated individual patients. Furthermore, the necessary participation of young patients and their families in decision-making is based on their feelings, wishes, medical knowledge, and health beliefs. Decisionmaking processes in child healthcare service systems are even more complex because of a lack of evidence-based data. Longterm observational studies on the benefit and risk of new models of child healthcare are scarce, and there is no guarantee that a successful model in 1 country will work in different countries with different health system characteristics. Last but not least, the group of opinion makers involves—in addition to pediatricians—other professionals, who have different interests and biases. Pediatric expert advice appears to have become an old style of authority in decision-making. Indeed, expert opinion can be wrong, and there are occasions when experts do not agree with each other. The concept of EBM also has its limits with regard to the process of medical decision-making, as it tends to place medicine in the field of the exact sciences such as mathematics. However, unlike exact sciences, child healthcare is less characterized by accurate quantitative expression, predictions, and hypotheses that can be tested by rigorous methods involving precise measurements. We will stress the importance of the role of expert opinion in the planning of child healthcare services in an era when EBM is mainly sought. Plato wrote that “opinion is something intermediary between knowledge and ignorance.” Authors conclude that pediatric expert opinions should be used complementary to evidencebased pediatrics. Opinions may change the pediatric world if based on solid data, practical experience, theoretical knowledge, and creative visions. Our experience of gathering information and expert opinions from our European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA) members for improving child healthcare in Europe is summarized in this article.

The Importance of Expert Opinion-Based Data: Lessons from the European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA) Research on European Child Healthcare Services.

Massimo Pettoello-Mantovani
Conceptualization
2018-01-01

Abstract

Evidence-based medicine (EBM) has gained great importance in child healthcare.Yet, the practical process of clinical decision-making is far more complex and ranges from highly sophisticated clinical trials to personal experience of a pediatrician on previously treated individual patients. Furthermore, the necessary participation of young patients and their families in decision-making is based on their feelings, wishes, medical knowledge, and health beliefs. Decisionmaking processes in child healthcare service systems are even more complex because of a lack of evidence-based data. Longterm observational studies on the benefit and risk of new models of child healthcare are scarce, and there is no guarantee that a successful model in 1 country will work in different countries with different health system characteristics. Last but not least, the group of opinion makers involves—in addition to pediatricians—other professionals, who have different interests and biases. Pediatric expert advice appears to have become an old style of authority in decision-making. Indeed, expert opinion can be wrong, and there are occasions when experts do not agree with each other. The concept of EBM also has its limits with regard to the process of medical decision-making, as it tends to place medicine in the field of the exact sciences such as mathematics. However, unlike exact sciences, child healthcare is less characterized by accurate quantitative expression, predictions, and hypotheses that can be tested by rigorous methods involving precise measurements. We will stress the importance of the role of expert opinion in the planning of child healthcare services in an era when EBM is mainly sought. Plato wrote that “opinion is something intermediary between knowledge and ignorance.” Authors conclude that pediatric expert opinions should be used complementary to evidencebased pediatrics. Opinions may change the pediatric world if based on solid data, practical experience, theoretical knowledge, and creative visions. Our experience of gathering information and expert opinions from our European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA) members for improving child healthcare in Europe is summarized in this article.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11369/368729
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