Caring with evidence based medicine

The task of evidence based medicine is to care for each patient. The “evidence based” adjective draws attention to the need to explicitly consider clinical research findings in caring for patients.1 In the 25 years since Guyatt first used the term, many tools—such as practice guidelines—have sought to bring evidence based medicine to all.

Three recent articles in The BMJ suggest that something got lost along the way and offer solutions. Yudkin and colleagues note that guidelines and clinicians overestimate the value of healthcare, and they suggest risk estimators to calibrate expectations. 2 Elwyn and colleagues think that guidelines are not built to support how clinicians use knowledge in practice in social, intuitive, and contextual ways and suggest new evidence conduits for the clinical encounter. 3 McCartney and colleagues join them in arguing that guidelines do not support evidence informed, individualised decision making. 4All three articles advocate …