Is evidence-based medicine overrated in family medicine? [La médecine fondée sur des données probantes est-elle surestimée en médecine familiale?]

摘要

It might seem strange to purport that evidence-based medicine (EBM) is overrated. It has been described as a Copernican revolution in medicine, celebrated as one of the most important ideas of the 20th century, and considered the leading movement in modern clinical medicine. It is claimed to be the standard by which all medicine should be practised.1 Surely arguing against EBM is akin to suggesting we return to the use of leeches and paternalistic authority. Prima facie there is no argument against the claim that medicine should be evidence-based. It certainly seems preferable to alternatives: Whimsy-based? No-good-reason-based? The idea that good medical decisions should be based on evidence is at once uncontroversial and platitudinous.