[Consensus conferences and guidelines in gastroenterology: an illusion]

Evidence-based medicine describes the present-day situation of a rational medicine which has its origins in the 19th century. At present evidence-based medicine is an ideal which is unattainable due to inadequate data from randomised controlled studies. Guidelines and consensus conferences which are not based on clearcut scientific data from controlled prospective and randomised studies fail to meet the requirements of evidence-based medicine and so cannot improve patient management. Guidelines and consensus conferences do not substantially reduce health costs.