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Evidence Based Medicine


For a relatively young country, Bangladesh is one of the most densely populated in the world. The country has been experiencing an average GDP growth of 5.72% from 1994 to 2016, with an all-time high of 7.05% in 2016, making it the one of the fastest growing major economies in the world. Although there has been significant development over the years, when it comes to healthcare, Bangladesh still has a long and hard path to overcome.

Born in London to parents of Bangladeshi origin, I spent most of my adult life residing in the UK and worked as a doctor in the National Health Service for the last 12 years. I had always pondered of ways in which I could contribute to Bangladesh’s health care sector but was unable to find any project that I believed in or could relate to.

Earlier this year, during a visit to Bangladesh, I had a rather unpleasant experience. My cousin was admitted to a renowned hospital in Dhaka and was misdiagnosed and provided wrong treatment for a simple case of appendicitis. I was quite baffled and appalled by the entire situation and the desire to ensure that people have the right to proper healthcare in Bangladesh grew stronger than ever.  

It was around this time that I heard about Praava Health from common friends and had the opportunity to meet with the Founder and CEO, Ms. Sylvana Sinha. After our first encounter, I was very intrigued by the concept and the idea she had to bring about a change in healthcare for Bangladesh. I knew that this was definitely something I wanted to be a part of and decided to explore it further. Six weeks after having met Sylvana, I decided to return to Bangladesh and become a part of Praava Health and hopefully a revolution in healthcare in the country. I currently work as the Senior Medical Director at Praava Health.

Praava Health aims to provide world class healthcare service at a price point that is affordable to the middle class. We believe that every individual deserves access to quality healthcare services and should be treated respectfully and with empathy – something that we so direly need in our country.

Medicine for me is a constant state of learning, and one aspect that I always focus on is Evidence Based Medicine. You might be wondering what exactly that means – let me explain it to you with my own experience. Soon after I completed medical school at Imperial College, many of the medical facts that I had learned were already obsolete. Medical professionals, such as myself, need to constantly stay updated with the latest developments in medicine to provide informed and accurate treatment. “Evidence Based Medicine” is the systematic use of current available evidence, including international medical journals or websites and applying strict criteria for the validity of the evidence. Sackett et al, 1996 describe evidence based medicine as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systemic research.

It is absolutely vital for any clinician or healthcare professional to practice evidence based medicine. This means that the decisions taken or policies made should be based on evidence to the greatest extent and not on assumptions. 

Numerous areas of research have increased awareness of the potential weaknesses in medical decision making at the level of both individual patients and populations, paving the way for the introduction of evidence based methods. Evidence quality can be assessed based on the source type (from meta-analyses and systematic reviews of randomized clinical trials with concealment of allocation and no attrition at the top end, down to conventional wisdom at the bottom), as well as other factors including statistical validity, clinical relevance, currency, and peer-review acceptance.

In Bangladesh, the practice of evidence based medicine is not extensive and that is something that I deeply believe needs to change. From my experience as a practicing surgeon in the UK and interning in Japan and Saudi Arabia, I have learned that the best possible care that one can provide is possible through evidence based medicine, and I hope to strictly follow that with Praava Health. There could be nothing more important than one’s health and there is nothing more important for a doctor than to ensure that it is taken care of.