[Is evidence based medicine a new paradigm in medical teaching?]

A great deal of enthusiasm has been generated by a learning strategy named Evidence-based medicine (EBM). It is claimed that EBM is a new paradigm that has revolutionized the practice of medicine. In this essay, we review the most stringent criticisms of these claims, opposing the generalized optimism prevalent among the followers of this trend. EBM is neither a new paradigm nor a revolutionary way of practicing medicine. It should be remembered that medicine has sought the best evidence available throughout history. Evidence used by EBM is only that based on meta-analysis and randomized clinical trials and ignores other types of useful evidence such as basic research and clinical experience. Promoting EBM as a new way of practicing medicine is treacherous and endangers the classical approach of the patient-physician relationship.