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Evidence-based medicine

Evidence-based medicine is a medical movement based upon the application of
the scientific method to the whole body of medical practice, including
long-established existing medical traditions that may never have been
subjected to systematic scrutiny. According to the Centre for Evidence-Based
Medicine,"Evidence-based medicine is the conscientious, explicit and
judicious use of current best evidence in making decisions about the care of
individual patients."

Professor Archie Cochrane was a British medical researcher whose book
Effectiveness and Efficiency: Random Reflections on Health Services (1972)
and subsequent advocacy caused increasing acceptance of the evidence-based
medicine concept. Cochrane's work was honoured through the naming of centres
of evidence-based medical research - Cochrane Centres - and an international
organisation - the Cochrane Collaboration.

Using techniques from science, engineering and statistics, such as
meta-reviews of the existing literature, risk-benefit analysis and
randomized controlled trials, it aims for the ideal that all doctors should
make "conscientious, explicit, and judicious use of current best evidence"
in making decisions about the care of individual patients.

Practising evidence-based medicine implies not only clinical expertise, but
expertise in retrieving, interpreting, and applying the results of
scientific studies, and in communicating the risks and benefit of different
courses of action to patients.

Critics of evidence-based medicine point out that doctors were doing this
already, that good evidence is often deficient in many areas, that lack of
evidence of benefit and lack of benefit are not the same, and that the more
data are pooled and aggregated the more difficult it is to compare the
patients in the studies with the one in front of you.

For all its problems, evidence-based medicine has very successfully demoted
the ex cathedra statement of the "medical expert" to the least valid form of
evidence--all experts must sprinkle their pronouncements with references to
the relevant literature.

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