Globalize the evidence, localize the decision: evidence-based medicine and international diversity

Even when the evidence about outcomes and effectiveness is clear, local circumstances dictate how that evidence is translated into practice. Opportunities have recently emerged to share evidence globally about the outcomes and effectiveness of health care (globalization) and then translate that evidence into improved health care at the local level (localization). To succeed in globalizing the evidence, policymakers must realize that opportunities to do so will be tempered by three competing core values: choice, efficiency, and equity.