[A global perspective on evidence-based medicine]

Evidence-based Medicine (EBM) has aroused considerable interest in Spain as a concept. Its original announcement in 1992 proposed a change in the paradigm in both the practice of medicine and how to teach it. That caused some controversy. The progressive improvement of both the quality of literature presentation and common understanding about the internal validity of studies can be attributed to its diffusion. EBM has also helped to disseminate new concepts like the NNT, more intuitive for the clinician. It has also fostered a variety of educational initiatives for the critical appraisal of the literature. Several initiatives for the compilation of sources screened for quality and oriented for application the practitioners' are ongoing, notably the Cochrane Collaboration, often using the features offered by the new technology. EBM has also contributed in some countries to formalize explicit policies to encourage directed clinical research.