[Evidence-based medicine vs personalized medicine.]

Evidence-based medicine (EBM) and personalized medicine (PM) are driven by two diverse modes of reasoning about «evidence making». EBM has been criticized since his quality mark has been misappropriated by vested interests, the benefits statistically significant may be marginal in clinical practice, rigid rules and technology may produce care that is management driven rather than patient centered. On the contrary PM (or "precision medicine") refers to the tailoring of medical treatment to the specific characteristics of each patient involving the ability to classify individuals into subpopulations that are uniquely susceptible to a specific treatment, sparing expense and side effects and is derived from doubts on the results of subgroup analyses and on non responders in clinical trials typical of EBM. While both paradigms are epistemically sound they cannot, and should not, be hybridized into a unique model. Rather they ought to represent two compatible, but alternative ways of informing the Clinical practice. The clinicians may expect to see their responsibility increasing as they will deal with diverse, but equally compelling ways of reasoning and deciding about which intervention will qualify as the «best one» in each individual case.