A personal account of the evidence for evidence-based medicine.

摘要

Evidence-based medicine should be divided into the old (OEBM) and the new (NEBM). The driving forces behind the NEBM, which started in the last decades of the 20th Century, included: 1. larger emphasis on empirical evidence rather than mechanical reasoning; 2. the newly proposed biopsychosocial model to explain especially the chronic diseases other than the older biomedical model, which was more successful in explaining infectious and acute diseases; 3. the unacceptable continuation of the popularity of non-scientific explanations of and remedies for many diseases; and 4. trying to control spiraling medical costs by central guidelines. The current most popular implementation of the NEBM is witnessed in preparing guidelines, which unfortunately became a promotional tool for industry in many instances. The remedy can be in returning to the original purpose of the NEBM, which was a new method of teaching the practice of-rather than practicing-medicine.