Directory of Opposing Views Resources

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Evidence-based medicine and its methodology, although now widely accepted, is still the subject of considerable critical assessment and debate, and the entries in this subcategory are intended to represent the broad range of critical assessment and appreciation of EBM from a number of perspectives.

Resources in This Category

• A categorization and analysis of the criticisms of Evidence-Based Medicine

  http://skynet.ohsu.edu/~hersh/ijmi-04-ebm.pdf
  An examination and assessment of a decade of critiques of EBM, categorized into five major themes. [2004]

• A philosophical analysis of the evidence-based medicine debate

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC169187/
  A review of criticisms of EBM as being founded on a lack of clarity and precision by EBM's own proponents.

• Bright and dark sides of evidence-based medicine

  http://pamw.pl/sites/default/files/inv_rev_Jassem.pdf
  A review of the most common shortcomings of randomized controlled trials (RCTs) as used in evidence-based medicine, with particular focus on publication bias. [2016]

• Counterpoint: Evidence-Based Medicine Lacks a Sound Scientific Base

  http://journal.publications.chestnet.org/article.aspx?articleid=1085845
  A critique of evidence-based medicine, especially its EBM-grading construct, as scientifically unsound. Part of a Point/Counterpoint exchange on EBM from the Chest journal. [2008]

• Criticisms of evidence-based medicine

  http://skynet.ohsu.edu/~hersh/ebcm-04-ebm.pdf
  Brief review of five major types of criticisms of EBM.

• Deconstructing the evidence-based discourse in health sciences: truth, power and fascism

  http://www.ucl.ac.uk/Pharmacology/dc-bits/holmes-deconstruction-ebhc-06.pdf
  The article that initiated the critical controversy surrounding the claim that EBM represents an exclusionary "regime of power".

• Evidence based medicine: a movement in crisis?

  http://www.bmj.com/content/348/bmj.g3725.long
  Argues that although evidence based medicine has had many benefits, it has also had some negative unintended consequences; the authors provide some constructive suggestions for addressing these concerns and limitations. [2014]

• Evidence based medicine: Can everything be evident?

  http://www.annals.in/article.asp?issn=0971-9784;year=2011;volume=14;issue=1;spage=3;epage=5;aulast=Kapoor
  HASH(0xbe920e0)

• Evidence based medicine—older, but no better educated?

  http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62286-2/fulltext
  A follow-up, 15 years hence (2010), of the lanmark audit in 1995, of the extent to which general medical inpatients were managed in an evidence-based manner in a large tertiary teaching hospital,. [2013]

• Evidence-based medicine - are we boiling the frog?

  http://www.scielo.org.za/scielo.php?pid=S0256-95742013000700016&script=sci_arttext
  Presents some limitations of EBM, especially the mistaking of statistical significance with clinical significance / relevance. [2013]

• Evidence-based medicine: a commentary on common criticisms

  http://www.cmaj.ca/content/163/7/837.full
  Review of the most commonly leveled charges against, and misperceptions about, evidence-based medicine, with proposed solutions to real limitations.

• Evidence-based medicine: can the evidence be trusted?

  http://ijme.in/articles/evidence-based-medicine-can-the-evidence-be-trusted/?galley=html
  Explores the problem of untrustworthy evidence, its sources and impact on quality in evidence-based medicine. [2011]

• Evidence-Based Medicine: Examining the Gap Between Rhetoric and Reality

  http://www.onclive.com/publications/oncology-live/2013/september-2013/Evidence-Based-Medicine-Examining-the-Gap-Between-Rhetoric-and-Reality
  A plea for a more thoughtful and critical re-examination of evidence-based medicine as it relates to optimal and personalized cancer management. [2013]

• Evidence-Based Medicine: Haute Couture or the Emperor's New Clothes?

  http://journals.lww.com/anesthesia-analgesia/Fulltext/2005/06000/Evidence_Based_Medicine__Haute_Couture_or_the.46.aspx
  An examination of some strengths and weaknesses of evidence-based medicine as it relates to the practice of anesthesiology.

• False dichotomies: EBM, clinical freedom, and the art of medicine

  http://mh.bmj.com/content/31/1/23.full
  A critical evaluation of the oft-cited criticism of evidence-based medicine as constraining clinical freedom and potentially compromising patient welfare. Published: 03/01/05. [Requires registration.]

• How evidence-based medicine is failing due to biased trials and selective publication

  http://onlinelibrary.wiley.com/doi/10.1111/jep.12147/full
  A sustained critique of evidence-based medicine's lack of independence given its high degree of industry-sponsored studies, but also offering some constructive suggestions for potential solutions. [2014]

• Is Evidence-Based Medicine Relevant to the Developing World?

  http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020107
  Argues and discusses the reasons for the limited relevance of systematic reviews to frontline health care workers in developing countries. [2005]

• Point: Evidence-Based Medicine Has a Sound Scientific Base

  http://journal.publications.chestnet.org/article.aspx?articleid=1085844
  A defense of evidence-based medicine as an evolving and highly individualized, patient-centered approach to clinical decision making. Part of a Point/Counterpoint exchange on EBM from the Chest journal. [2008]

• The case against 'the evidence': a different perspective on evidence-based medicine

  http://bjp.rcpsych.org/cgi/content/full/180/1/8?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1127920476751_4679&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=180&firstpage=8&resourcetype=1
  A psychiatrist's critique that over-emphasis on evidence-based medicine oversimplifies the complex and interpersonal nature of clinical care.

• The Evidence-based Medicine Paradigm: Where are We 20 Years Later? Part 1

  http://journals.cambridge.org/download.php?file=/CJN/CJN40_04/S0317167100014542a.pdf&code=97d58b3738d791d8535dff80e4f96db5
  Critical review of progress in, and limitations, of evidence-based medcine methodology over the two decades since inception. [2013]

• The Evidence-based Medicine Paradigm: Where are We 20 Years Later? Part 2

  http://journals.cambridge.org/download.php?file=/CJN/CJN40_04/S0317167100014554a.pdf&code=cbc40d6a5ea07503d4063bbf512011e1
  Critical review of progress in, and limitations, of evidence-based medcine over the two decades since inception. [2013]

• The pragmatic randomised controlled trial

  http://apt.rcpsych.org/content/8/5/326.full
  A critique of conventional randomized controlled trials methodology, and an attempt to incorporate more complex interventions via a new 'pragmatic RCT'.

• The Real World Failure of Evidence-Based Medicine

  http://www.donaldmiller.com/Real_World_Failure_of_Evidence-Based_Medicine.pdf
  Argues that EBM is an ad hoc construct and not a valid basis for medical decision-making. [2011]

• Trials | Full text | Randomised trials in context: practical problems and social aspects of evidenc

  http://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-0917-5
  Critical examination of four important ways in which the evidence from randomised trials is limited or partial, that are claimed to undermine the evidence that such trials provide for decision-making. [2015]

• Why Evidence-Based Medicine Cannot Be Applied to Psychiatry

  http://www.psychiatrictimes.com/display/article/10168/1153248?pageNumber=1
  Argues that there is insufficient proof that the EBM model can be adapted to fit psychiatry. (April 1, 2008).

 

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