Evidentiary challenges to evidence-based medicine.

Journal Article (Journal Article)

The evidence-based medicine (EBM) movement has exerted a strong influence on contemporary medicine. It has been used to define the hierarchy of knowledge in clinical medicine by classifying clinical findings according to the perceived relevance and validity of the respective methodologies of studies from which evidence was collected. In the spectrum of theories of knowledge, EBM predominantly relies on findings obtained from population-derived clinical research. This reliance on knowledge obtained from population studies sharply contrasts with a physiologic model of clinical knowledge advocated by basic science researchers and many clinicians. An apparent schism between proponents of physiologic and population models in the approach to the practice of medicine has been created. This dichotomy between practising physicians and EBM physicians in the approach to clinical knowledge should not be irreconcilable. We advocate a consilient approach to the interpretation of evidence and the integration of medical knowledge. This approach relies on 'linking of facts and fact-based theory across various disciplines to create a common groundwork of explanation'.

Full Text

Duke Authors

Cited Authors

  • Djulbegovic, B; Morris, L; Lyman, GH

Published Date

  • May 2000

Published In

Volume / Issue

  • 6 / 2

Start / End Page

  • 99 - 109

PubMed ID

  • 10970004

International Standard Serial Number (ISSN)

  • 1356-1294

Digital Object Identifier (DOI)

  • 10.1046/j.1365-2753.2000.00226.x


  • eng

Conference Location

  • England