[Evidence-based medicine vs personalized medicine.]

Area of Science:

• Medical Ethics
• Clinical Practice Guidelines
• Health Services Research

Background:

• Evidence-based medicine (EBM) faces criticism regarding statistical significance, potential for management-driven care, and misappropriation of its quality mark.
• Personalized medicine (PM), or precision medicine, tailors treatments to individual patient characteristics, addressing limitations of EBM subgroup analyses and non-responders.

Purpose of the Study:

• To analyze the distinct reasoning modes of EBM and PM.
• To evaluate the compatibility and potential hybridization of EBM and PM.
• To explore the implications for clinical practice and clinician responsibility.

Main Methods:

• Conceptual analysis of the epistemological foundations of EBM and PM.
• Critical review of the methodologies and outcomes associated with EBM and PM.
• Exploration of the practical application of distinct reasoning models in clinical decision-making.

Main Results:

• EBM and PM represent fundamentally different, yet epistemically sound, methods of evidence utilization.
• Hybridizing EBM and PM into a single model is not advisable.
• Both paradigms offer valuable, albeit alternative, frameworks for informing clinical practice.

Conclusions:

• EBM and PM should be viewed as compatible but distinct approaches to healthcare.
• Clinicians will increasingly navigate diverse and compelling reasoning methods to determine optimal patient interventions.
• The future of clinical practice involves managing multiple, equally valid, evidence-based decision-making pathways.