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Related Experiment Videos

Who will challenge evidence-based medicine?

N W Goodman1

  • 1Department of Anaesthesia, Southmead Hospital, Bristol.

Journal of the Royal College of Physicians of London
|July 14, 1999
PubMed
Summary

Evidence-based medicine (EBM) is attractive for finding best treatments but faces unanswered questions regarding its assumptions. Critics and advocates engage in limited dialogue, risking EBM becoming an unchallengeable orthodoxy.

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Area of Science:

  • Medical research methodology
  • Clinical practice guidelines
  • Health policy analysis

Background:

  • Evidence-based medicine (EBM) emphasizes systematic reviews and meta-analyses for treatment selection.
  • The formal gathering and synthesis of research data are central to EBM's approach.
  • EBM is widely considered attractive for determining optimal medical interventions.

Purpose of the Study:

  • To critically evaluate the underlying assumptions of Evidence-based medicine.
  • To examine the discourse between EBM advocates and critics.
  • To assess the potential for EBM to become a rigid, politically driven orthodoxy.

Main Methods:

  • Analysis of the core tenets and assumptions of Evidence-based medicine.
  • Review of the existing dialogue and disagreements within the medical community regarding EBM methods.
  • Assessment of the potential for EBM to develop into an unchallengeable doctrine.

Main Results:

  • Significant questions persist regarding the foundational assumptions of EBM.
  • There is a notable lack of substantive dialogue between EBM's proponents and detractors.
  • Internal disagreements among EBM advocates highlight methodological uncertainties.
  • Concerns exist that EBM may evolve into a dogmatic and politically influenced system.

Conclusions:

  • The underlying assumptions of Evidence-based medicine require further critical examination.
  • Enhanced dialogue and debate are necessary to address EBM's limitations and potential biases.
  • The risk of EBM becoming an inflexible orthodoxy with its own agenda must be actively mitigated.

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