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["Evidence-based medicine": strength and weakness of evidence]
1Vakgroep Maatschappelijke Gezondheidkunde, UGent De Pintelaan 185-B 9000 Gent.
Abstract:
In order to identify the strengths and weaknesses of evidence it is necessary to agree on the definition of the concept of evidence based medicine (EBM). EBM can be considered as a way of thinking arguing that health care decisions need to be focused on research-based evidence. Strength of evidence can be graded; different hierarchical systems have been proposed and create more confusion than clarity. "Quality implies being fit for purpose" should guide the further development of EBM. Questions on aetiology, diagnosis, prognosis, or on the efficacy and safety of preventive or curative actions in medicine can not be answered by one and the same study design. EBM has strengths that should be used and further developed; it has limitations; it is not a panacea for resolving all questions that can raise in medical decisions.
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