BMJ  2005;330:92 (8 January), doi:10.1136/bmj.330.7482.92

Letter

Evidence based medicine: does it make a difference?

Use wisely

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

EDITOR—The term "evidence based medicine" entered the scientific lexicon only a little more than a decade ago.¹ What caused its remarkable spread, and what are the implications of its broad and rapid diffusion?

The team that coined the term at first considered using the phrase "scientific medicine" but rejected it because it implied that other approaches were by definition unscientific.² However, critics have argued that the term evidence based medicine carries a similar moral valence and linguistic slipperiness.³ Who could argue against the notion of providing care that integrates individual clinical skill and the best external evidence?⁴

Originally developed as a method for teaching medical residents, evidence based medicine is being applied ever more broadly to the organisation and delivery of medical services. Multiple stakeholders now seek to assume its mantle for purposes that often contradict its original intent.

Managers, equating lack of evidence with lack of effectiveness, . . . [Full text of this article]

Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA bdruss@emory.edu

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