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The principles of using the best knowledge for medical practice is as old as medicine, but the concept of “Evidence-based medicine (EBM)” is relatively new. The meaning of this is “ the integration of best research evidence with clinical expertise and patient

values”. EBM was primarily developed for clinical health care, but the concept “evidence based medicine” has also been introduced in the occupational prevention field  and it has also  been introduced in maritime medicine. The EBM process´ main issues are:

• Defining the question(s) that needs to be answered

• Collecting the evidence to answer the question

• Critical appraisal of the evidence gathered

• Integration of the evidence and patient factors choose treatment

• Evaluation of the treatment effect.  

This sequence of thinking can be applied in patients and in populations as well. If no adequate evidence is available, we may have a relevant research question. So the use of the principle of thinking has two main objectives: 1) The critical use of the existing knowledge to give the best treatment and 2) formulating of new research questions. Much of the basic elements in maritime medicine, like malaria prophylaxis or hyperbaric medicine are shared with other medical specialities with a large amount of published knowledge. The sparse knowledge in most areas of the maritime health and safety is contrasting to this and there seems to be huge gab of knowledge in many issues.