The burden of evidenceBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7308.349 (Published 11 August 2001) Cite this as: BMJ 2001;323:349
- Jerry L Rushton, clinical lecturer
- Michigan, USA
Evidence based medicine has advanced our science and helped doctors move from inconsistent, often unsupported, practices based on our last case and anecdotal experience to more uniform, effective care. Rigorous methodology has facilitated efforts to deliver high quality treatment and improve outcomes for large patient populations. We have elevated the science published in journals and presented at meetings. Elegant randomised controlled clinical trials, meta-analyses, and guidelines have changed the support of our recommendations from “because I said so” towards “because we know so.” Cost analyses have provided means to allocate our tightening resources efficiently and allow doctors and health systems to survive in an era of intense financial pressure.
We must trust our own knowledge and individual “expert opinion”
However, in the wake of these achievements, the burden of evidence based medicine may have untoward effects on relations between patients and doctors, on personal satisfaction, and on artistic components of the “art of medicine.”
Doctor scientists at all levels …