EBM in Poland - how it all started

Evidence-based medicine (EBM) has been introduced into Poland in the late 1990s. It was introduced through the workshops led by Professor Roman Jaeschke and Professor Gordon Guyatt from McMaster University (Hamilton, Ontario, Canada). The ideas were supported by Medycyna Praktyczna (a Publishing House) and the Polish National Centre for Quality Assessment in Healthcare (NCQA). The activities included providing EBM courses for physicians and other health professionals, publication of Polish version of ‘Users’ guide to the medical literature’ (prepared by Prof. Roman Jaeschke, Prof. Deborah Cook and Prof. Gordon Guyatt), as well as promoting use of the results of clinical trials and systematic reviews in everyday practice. Finally, preparation of practice guidelines and health technology assessment (HTA) reports were also advocated as components of the EBM framework. Several employees of EBM team in NCQA participated in hand searching workshops at the Nordic Cochrane Centre in Copenhagen. Soon after that NCQA became a Centre affiliated with the Nordic Cochrane Centre, and Małgorzata M. Bała, M.D., Ph.D., became the national contact person. The activities of the Centre affiliated with the Nordic Cochrane Centre included hand searching of Polish medical journals not indexed in Medline, providing the translation of Cochrane brochure and translations for Cochrane authors. A number of articles about the Cochrane Collaboration were published in Polish medical journals.

The climate for EBM and HTA changed in Poland and HTA Agency was founded, guidelines for preparing HTA reports were developed (which also followed EBM principles). In 2007 Polish HTA Agency in cooperation with Polish Ministry of Health organised national access to the Cochrane Library, together with contest on the best description of the use of Cochrane systematic review in everyday practice. The access was funded for two years and then it was discontinued due to problems with funding.

Medycyna Praktyczna organised EBM team which has been very active in implementing EBM ideas in Poland. The activities carried out by the team included EBM courses, publishing EBM manual, development of an EBM handbooks, preparing structured summaries of clinically relevant trials and systematic reviews, and also developing practice guidelines. Some of the members of this EBM team are a core of Polish Branch of Nordic Cochrane Centre – as members of the staff/collaborators or as members of its Advisory Board.

Some of the team members have played significant role in implementing the EBM basics into the curricula of medical studies in Poland. Accordingly, in 2004 Jagiellonian University Medical College had included EBM into their medical curriculum (initially as an optional course, currently holding the obligatory status). In 2005 Jagiellonian Univeristy Medical College established Clinical Decision Unit (EBM unit) within 2nd Department of Internal Medicine (head: Prof. Anetta Undas, M.D., Ph.D.), which has been carrying out EBM teaching and preparing systematic reviews. Ever since the team members have been actively developing the EBM awareness among the clinicians-to-be in Poland, by holding EBM classes at the Jagiellonian University Medical College.

Finally, the community of EBM practitioners in Cracow have been involved in developing clinical guidelines and systematic reviews (including Cochrane reviews), concurrently expanding research networks in Poland and abroad.