[Evidence-based medicine: a movement in crisis?]

Area of Science:

• Medical Research
• Clinical Practice
• Health Policy

Context:

• The evidence-based medicine (EBM) movement is experiencing significant challenges.
• A recent BMJ paper highlights concerns regarding EBM's current state and future direction.
• Issues include the misappropriation of the EBM "quality mark" by vested interests.

Purpose:

• To critically analyze the current crisis within the evidence-based medicine movement.
• To identify key factors contributing to the perceived decline of EBM principles.
• To propose solutions for revitalizing EBM and ensuring patient-centered care.

Summary:

• The EBM movement faces a crisis, with its "quality mark" co-opted by vested interests.
• The overwhelming volume of evidence and clinical guidelines is unmanageable.
• Statistically significant benefits may be marginal in practice, and rigid protocols can lead to management-driven, rather than patient-centered, care.
• Evidence-based guidelines often fail to adequately address complex multimorbidity.

Impact:

• A call for a campaign for "real EBM" is advocated, urging patients to demand better, personalized evidence.
• Stakeholders, including researchers and publishers, must collaborate to realign with EBM's founding principles.
• Addressing these issues is crucial for improving the quality and relevance of medical evidence in clinical practice.