When evidence-based medicine (EBM) was announced in the early 90s, according to a paper in the Journal of Evaluation in Clinical Practice, it was hailed as a ‘new paradigm’ for improving care. Now “health care costs have increased while there remains a lack of high-quality evidence suggesting EBM has resulted in substantial population-level health gains,” the paper states, asserting that “EBM’s potential for improving patients’ health care has been thwarted by bias in the choice of hypotheses tested, manipulation of study design and selective publication.” Every-Palmer, S., Howick, J.; How evidence-based medicine is failing due to biased trials and selective publication. Journal of Evaluation of Clinical Practice. Online May 12, 2014. doi: 10.1111/jep.12147.
A false economy . . . (1 Boring Old Man)
From the article:
“I don’t respond positively to the term Evidence Based Medicine [EBM]. I’ve most often heard it used to elevate the Randomized Clinical Trial [RCT] or somebody’s Guideline to the level of binding truth.”