BMJ  2004;329 (30 October), doi:10.1136/bmj.329.7473.0-h

Editor's choice

From optimism to hubris

The first 150 words of the full text of this article appear below.

This theme issue—on whether evidence based medicine makes a difference—makes balanced nods in the direction of both advocates and critics of EBM. It begins with optimism and ends with hubris. Yet among the systematic reviews, randomised controlled trials, anecdotes, and speculation a picture does emerge. There are positive answers to many questions that are asked about EBM: Does it benefit patients? How do you teach it? How do you change practice?

The clearest messages are probably about how to teach it and how to change practice. Arri Coomarasamy and Khalid Khan's systematic review (p 1017) shows that when teaching EBM is integrated into clinical practice it improves skills, attitudes, and behaviour as well as knowledge. The importance of integration with clinical practice fits well with the ethnographic analysis by Gabbay and le May (p 1013) of how general practices handle and integrate evidence. Their answer, through . . . [Full text of this article]

Jane Smith, deputy editor

(jsmith@bmj.com)


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