Evidence-Based Medicine: A Movement in Crisis?

The document discussed the challenges faced by the evidence-based medicine (EBM) movement, highlighting concerns that it was in crisis due to an overemphasis on randomized controlled trials and systematic reviews, which sometimes neglected individual patient needs. It pointed out that commercial interests and complex healthcare systems compromised EBM's integrity. Critics argued that EBM had been misappropriated, leading to overwhelming evidence and guidelines that were difficult to manage, resulting in management-driven rather than patient-centered care. The authors called for a renaissance of EBM, emphasizing individualized evidence, expert judgment, shared decision-making, and a strong clinician-patient relationship. They advocated for better evidence presentation, interdisciplinary research, and resistance to vested interests to achieve real EBM, promoting transparency in clinical trials and improving medical education and publishing standards.