Evidence-based medicine

The first step: Gathering information

Many health-related decisions can be made without specifically looking for information. But when a decision starts becoming more complex, it's important to have reliable information about the various treatment options. We have put together a list of questions that may help you reach a clear decision.

Question 1: What exactly is the disease or health problem I am dealing with?

If you're not sure which health problem or treatment you're dealing with, don't hesitate to ask your doctor. Doctors have a duty to inform their patients. This means that they must fully inform you about your condition and all the treatment options. This also includes information about possible positive or negative effects of the therapy.

Knowing the medical terms can often help you get more information too, for example when searching the internet. But make sure you use the right term: For instance, the medical term for high blood pressure is hypertension, which can easily be confused with hypotension – the term for low blood pressure.

Question 2: What consequences will the medical condition have?

The answer to this question is very important when deciding about a treatment. If a condition is likely to get better on its own within seven days, and the treatment only shortens this time by half a day, some people might not think it is worth having. For example, people who have acute sinusitis are usually healthy again within two weeks – regardless of whether they take medication or not.

The medical term for how a condition will most likely develop is "prognosis." A prognosis can't tell you for sure what will happen, though, because an illness or treatment can have very different effects in different people. But a reliable prognosis will at least tell you how a disease usually progresses.

Ideally you will find information on how your medical condition usually progresses in people who are similar to you. These may be people who

  • are about the same age as you,
  • are of the same sex (male or female),
  • have the same stage of disease as you (mild or severe), or
  • are in a similar general state of health (for instance, if you're otherwise healthy or have other medical conditions too).

Question 3: What treatment options do I have?

The following questions may help you find out what your options are:

  • What can I do myself?
  • Do I need medication? What (prescription and over-the-counter) medications are available?
  • What non-drug treatment options are there?
  • What surgical options are there?
  • What costs would be covered by my health insurance?

Many people are also interested in alternative or complementary treatments. But the same criteria and requirements apply to these treatments as to other types of treatment.

Practical information also helps:

  • Where can I get the treatment?
  • How long will it take?
  • How much could it cost?
  • How much will it limit my daily activities?

Question 4: What are the possible advantages and disadvantages of the treatment options?

All treatments can have side effects, even if they're often only mild. The following questions can help you weigh the benefits and harms of a treatment:

  • How likely am I to benefit from the treatment at all?
  • How great are the benefits of the treatment? Will I feel a slight improvement or maybe even get completely healthy again?
  • How likely are side effects?
  • What are the potential harms of the treatment? For example, what is the lowest dose of medication that would still help me and at the same time have as few side effects as possible?
  • When will it start working, and how long will the effect last? At what time of day would side effects be likely?
  • Could the effects of the treatment be influenced by other treatments (such as over-the-counter medications or dietary supplements)?
  • Could the treatment affect my everyday life? For example, will it affect my ability to concentrate, or will I have to stop working for a while?
  • And here, too: Where is the treatment available?

Question 5: Is there good research on the treatments?

Some treatments have been known and used for a long time. Their effects have generally been well studied. They might also be considered to be the standard therapy, meaning that new treatments are compared with this known and established therapy. Or they might be too new for there to be much research on long-term effects.

If, for instance, a drug has been on the market for less than five years, it's regarded as a relatively new treatment. Generally speaking, not much will be known about its side effects after such a short time – especially in people who have several illnesses. The benefits and side effects of many treatments haven't been properly studied yet. But it is often possible to find out how reliable the available facts are.

If you need more information, talk to your doctor or another healthcare professional, or ask at your pharmacy. If you have found new information, it may be helpful to talk with your doctor again in order to ask any questions that are important to you.

You can also consult a second doctor. A second opinion often gives you more security – especially when you're dealing with a serious disease, a complex decision, or a rare medical problem.

Talking with others who have the same condition, or with your family and friends, can also help you figure out what's important to you. Or you can turn to a patient information center or another patient organization. Ultimately, every health-related decision is a very personal matter: What others consider to be right for them is not necessarily the best option for you too.