What Evidence in Evidence‐Based Medicine?

Evidence‐Based Medicine is a relatively new movement that seeks to put clinical medicine on a firmer scientific footing. I take it as uncontroversial that medical practice should be based on best evidence—the interesting questions concern the details. This paper tries to move towards a coherent and unified account of best evidence in medicine, by exploring in particular the EBM position on RCTs (randomized controlled trials).

[1]  J. Concato,et al.  Randomized, controlled trials, observational studies, and the hierarchy of research designs. , 2000, The New England journal of medicine.

[2]  D. Sackett,et al.  Evidence based medicine: what it is and what it isn't , 1996, BMJ.

[3]  A D Oxman,et al.  The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials , 1998, BMJ.

[4]  T C Chalmers,et al.  Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. , 1977, The New England journal of medicine.

[5]  A. Hartz,et al.  A comparison of observational studies and randomized, controlled trials , 2000, American journal of ophthalmology.

[6]  J. Tukey Some thoughts on clinical trials, especially problems of multiplicity. , 1977, Science.

[7]  Peter Urbach,et al.  Scientific Reasoning: The Bayesian Approach , 1989 .

[8]  P. Urbach,et al.  The value of randomization and control in clinical trials. , 1993, Statistics in medicine.

[9]  P. Armitage,et al.  Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. , 1976, British Journal of Cancer.

[10]  S. Pocock,et al.  Clinical Trials: A Practical Approach , 1984 .

[11]  Bias in treatment assignment in controlled clinical trials. , 1984, The New England journal of medicine.

[12]  J. Ware,et al.  Randomized clinical trials. Perspectives on some recent ideas. , 1976, The New England journal of medicine.

[13]  J. I The Design of Experiments , 1936, Nature.

[14]  Ronald N. Giere,et al.  Understanding Scientific Reasoning , 1979 .

[15]  G. Grégoire,et al.  Discrepancies between meta-analyses and subsequent large randomized, controlled trials. , 1997, The New England journal of medicine.

[16]  Peter Urbach,et al.  Randomization and the Design of Experiments , 1985, Philosophy of Science.

[17]  N. Black Why we need observational studies to evaluate the effectiveness of health care , 1996, BMJ.

[18]  S. Gore Statistics in question , 1981 .

[19]  R Doll,et al.  Randomised controlled trials and retrospective controls. , 1980, British medical journal.

[20]  David Papineau,et al.  The Virtues of Randomization , 1994, The British Journal for the Philosophy of Science.

[21]  J K Harcourt,et al.  Effectiveness and efficiency. , 1992, Australian dental journal.