[Evidence-based medicine: an introduction for clinical practitioners]

Area of Science:

• Medical research methodology
• Clinical practice guidelines
• Healthcare ethics

Context:

• The term "evidence-based medicine" (EBM) is understood differently in Germany compared to English-speaking countries.
• Continental European understanding of "evidence" implies self-evidence and clarity.
• Anglo-Saxon understanding defines "evidence" as disputable facts supporting a proposition's validity.

Purpose:

• To clarify the semantic differences in the understanding of "evidence" in medicine.
• To highlight the necessity of "external evidence" from clinical research for medical indication rules.
• To discuss the ethical implications of EBM.

Summary:

• "Evidence-based medicine" (EBM) adoption in Germany is hindered by contrasting definitions of "evidence."
• While both self-evident and empirical evidence are vital in clinical medicine, "external evidence" from rigorous research is currently essential for establishing clinical indication rules.
• The consequentialist rationale of EBM, focusing on intervention effectiveness, is examined alongside its ethical challenges.

Impact:

• Promotes a clearer understanding of EBM terminology in non-English speaking regions.
• Emphasizes the critical role of robust clinical research in shaping medical practice and guidelines.
• Initiates discussion on the ethical framework required for implementing EBM effectively.