Document Detail

Where is the wisdom? I--a conceptual history of evidence-based medicine.
MedLine Citation:
PMID:  20367679     Owner:  NLM     Status:  MEDLINE    
Rationale Evidence-based medicine (EBM) has been acclaimed as a major advance in medical science, but criticized as a proposed alternative model for the practice and teaching of medicine. Ambiguity regarding the proper role of the contributions of EBM within the fabric of medicine and health care has contributed to this discrepancy. Aims and objectives We undertook a critical review of the history of the EBM movement, beginning with its origins in the 1970s and continuing through this century. We drew upon the results of an independent project that rationalized the EBM domain from the perspective of educational evaluation and assessment. We considered the content of EBM in relationship to the propositions and promises embodied in advocacy publications. Results EBM emerged in the context of the explosion of biomedical information in the decade preceding public access to the Internet in the mid-1990s and drew upon the independently derived 'information literacy' formula developed by information scientists during the 1980s. The critically important content and achievements of EBM are fully explained within the confines of the information literacy model. The thesis that EBM offers an alternative paradigm for individualized health care, asserted in the advocacy literature, is not supported by published models of evidence-based clinical practice. Conclusion A critical historical review of the origins, content and development of the EBM movement proposes that full integration of the fruits of the movement into routine clinical care remains a conceptual and practical challenge.
Peter C Wyer; Suzana A Silva
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  15     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-04-06     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  891-8     Citation Subset:  IM    
Associate Clinical Professor of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10803, USA.
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MeSH Terms
Computational Biology / history
Diffusion of Innovation
Evidence-Based Medicine / history*
History, 20th Century
History, 21st Century
Information Dissemination / history

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