Evidence-based medicine

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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 techniques that may never have been subjected to systematic scrutiny.

Using techniques from engineering and statistics, such as meta-reviews of the existing literature, and risk-benefit analysis, 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, 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. The expert is dead! Long live the expert!

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