Evidence-based medicine: the need for a new definition

Area of Science:

• Medical research methodology
• Philosophy of science
• Health policy analysis

Background:

• Current evidence-based medicine (EBM) primarily equates evidence with scientific findings.
• Clinical expertise and other factors are considered secondary in EBM's evidence-to-action framework.
• This narrow definition may limit the scope and defensibility of medical judgments.

Purpose of the Study:

• To propose an expanded definition of evidence within evidence-based medicine (EBM).
• To advocate for the inclusion of multiple dimensions of evidence beyond scientific data.
• To argue that this broader perspective enhances clinical judgment and decision-making.

Main Methods:

• Conceptual analysis of the definition and scope of evidence in EBM.
• Critique of the limitations of a purely science-centric approach to medical evidence.
• Argumentation for integrating diverse evidence types into EBM.

Main Results:

• Identified limitations in the current EBM definition's reliance on scientific evidence alone.
• Proposed multiple dimensions of evidence: scientific, theoretic, practical, expert, judicial, and ethics-based.
• Highlighted the loss of comprehensive judgment capabilities in current EBM.

Conclusions:

• Evidence-based medicine (EBM) requires a broader definition encompassing diverse evidence types.
• Acknowledging multiple dimensions of evidence enriches clinical decision-making and judgment.
• An inclusive EBM framework can integrate evidence from both within and outside traditional scientific paradigms.