Progress in evidence-based medicine: a quarter century on

Area of Science:

• Clinical Medicine
• Medical Informatics

Background:

• The early 1990s saw the rise of evidence-based medicine (EBM) due to challenges in using published research.
• Initial EBM focused on clinician education in literature appraisal and systematic reviews.

Observation:

• EBM evolved beyond solely relying on evidence, incorporating patient values and preferences through shared decision-making.
• The practice advanced by integrating and refining the science of developing trustworthy clinical practice guidelines.

Findings:

• EBM established a scientific foundation for medical practice.
• Key contributions include advanced evidence hierarchies, recognizing patient values in decision-making, and developing robust guideline methodologies.

Implications:

• EBM enhances clinical decision-making by synthesizing evidence with patient-centered care.
• The development of reliable clinical practice guidelines ensures better patient outcomes.
• EBM promotes a rigorous, evidence-informed approach to healthcare delivery.