Reference:
Djulbegovic, B., & Guyatt, G. H. (2017). Progress in evidence-based medicine: A quarter century on. The Lancet, 390(10091), 415-423. http://doi.org/10.1016/S0140-6736(16)31592-6
Summary:
This article traces the evolution of evidence-based medicine (EBM) over 25 years, highlighting its origins in the early 1990s and initial focus on educating clinicians on the use of published research. EBM has since progressed to emphasise the integration of clinical evidence with patient values through shared decision-making. It has also led to the formulation of rigorous clinical practice guidelines. The article reviews the historical context of EBM, its philosophical foundations, and the development of evidence hierarchies. It discusses how EBM has improved medical practice by promoting systematic reviews and addressing biases in research. Moreover, it identifies ongoing challenges such as the need for a coherent theory of decision-making and the role of patient preferences. The authors conclude that EBM’s contributions to clinical medicine, including the emphasis on critical appraisal and the importance of patient involvement, will continue to shape healthcare practices.