Intended for healthcare professionals

Views & Reviews From the Frontline

Evidence based medicine is broken

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g22 (Published 03 January 2014) Cite this as: BMJ 2014;348:g22
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}yahoo.co.uk

Evidence based medicine (EBM) wrong footed the drug industry for a while in the 1990s. We could fend off the army of pharmaceutical representatives because often their promotional material was devoid of evidence. But the drug industry came to realise that EBM was an opportunity rather than a threat. Research, especially when published in a prestigious journal, was worth more than thousands of sales representatives. Today EBM is a loaded gun at clinicians’ heads. “You better do as the evidence says,” it hisses, leaving no room for discretion or judgment. EBM is now the problem, fueling overdiagnosis and …

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