Evidence-based medicine

This article explores the philosophical and ethical issues raised by evidence-based medicine (EBM). EBM is a process of searching and summarizing research evidence to guide the clinical care of patients. EBM developed as a method of identifying and integrating the best available current evidence about effectiveness, in order to avoid the use of harmful or ineffective interventions and to ensure the rapid uptake into practice of new and effective interventions. The impetus behind EBM is to provide a scientific basis for medical care, based on unbiased research methods – notably the randomized controlled trial – and to protect patients from harm, provide treatments that are safe and effective, and promote equity in access to effective treatments. EBM has been criticized for its overreliance upon the randomized controlled trial, for itself lacking a scientifically valid basis, and for ethical issues related to the production and use of research evidence.