{"title":"循证医学的假设已变成神话","authors":"Fradis Gil-Olivares , Carlos Alva-Diaz , Isabel Pinedo-Torres , Niels Pacheco-Barrios , Karina Mayra Aliaga Llerena , Mariela Huerta-Rosario","doi":"10.1016/j.edumed.2024.100887","DOIUrl":null,"url":null,"abstract":"<div><p>“Evidence-based medicine” (EBM) proposes methods, techniques, and instruments for verifying, incorporating, and applying scientific information in individual and public health. However, the principles and postulates of EBM have evolved over time. Our objective was to analyze the principles and postulates of EBM and compare them with current research, to identify possible myths. We conducted a review and analysis of the literature to identify the current principles of EBM and its most disseminated postulates. Subsequently, we compared these postulates with scientific evidence and EBM principles to identify potential myths. We identified 3 current principles of EBM: “EBM is a systematic summary of the best available evidence”, “EBM provides guidance to determine the level of confidence in estimates”, and “Evidence is never enough to drive clinical decision making.” Additionally, we identified 4 widely disseminated postulates: (1) Systematic reviews are at the top of the evidence pyramid, (2) randomized clinical trials are the best type of evidence, (3) expert opinion is a type of scientific evidence, and (4) to make health decisions, we should only use scientific publications. We critically assessed these postulates against scientific evidence and EBM principles, revealing them to be \"myths.\" We identified f4 myths of EBM and proposed solutions to foster a more accurate interpretation and utilization of scientific evidence.</p></div>","PeriodicalId":35317,"journal":{"name":"Educacion Medica","volume":"25 3","pages":"Article 100887"},"PeriodicalIF":0.0000,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1575181324000020/pdfft?md5=977f109e3324c00071537e6e9e65c735&pid=1-s2.0-S1575181324000020-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Postulates of evidence-based medicine have transformed into myths\",\"authors\":\"Fradis Gil-Olivares , Carlos Alva-Diaz , Isabel Pinedo-Torres , Niels Pacheco-Barrios , Karina Mayra Aliaga Llerena , Mariela Huerta-Rosario\",\"doi\":\"10.1016/j.edumed.2024.100887\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>“Evidence-based medicine” (EBM) proposes methods, techniques, and instruments for verifying, incorporating, and applying scientific information in individual and public health. However, the principles and postulates of EBM have evolved over time. Our objective was to analyze the principles and postulates of EBM and compare them with current research, to identify possible myths. We conducted a review and analysis of the literature to identify the current principles of EBM and its most disseminated postulates. Subsequently, we compared these postulates with scientific evidence and EBM principles to identify potential myths. We identified 3 current principles of EBM: “EBM is a systematic summary of the best available evidence”, “EBM provides guidance to determine the level of confidence in estimates”, and “Evidence is never enough to drive clinical decision making.” Additionally, we identified 4 widely disseminated postulates: (1) Systematic reviews are at the top of the evidence pyramid, (2) randomized clinical trials are the best type of evidence, (3) expert opinion is a type of scientific evidence, and (4) to make health decisions, we should only use scientific publications. We critically assessed these postulates against scientific evidence and EBM principles, revealing them to be \\\"myths.\\\" We identified f4 myths of EBM and proposed solutions to foster a more accurate interpretation and utilization of scientific evidence.</p></div>\",\"PeriodicalId\":35317,\"journal\":{\"name\":\"Educacion Medica\",\"volume\":\"25 3\",\"pages\":\"Article 100887\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1575181324000020/pdfft?md5=977f109e3324c00071537e6e9e65c735&pid=1-s2.0-S1575181324000020-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Educacion Medica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1575181324000020\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Educacion Medica","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1575181324000020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Social Sciences","Score":null,"Total":0}
Postulates of evidence-based medicine have transformed into myths
“Evidence-based medicine” (EBM) proposes methods, techniques, and instruments for verifying, incorporating, and applying scientific information in individual and public health. However, the principles and postulates of EBM have evolved over time. Our objective was to analyze the principles and postulates of EBM and compare them with current research, to identify possible myths. We conducted a review and analysis of the literature to identify the current principles of EBM and its most disseminated postulates. Subsequently, we compared these postulates with scientific evidence and EBM principles to identify potential myths. We identified 3 current principles of EBM: “EBM is a systematic summary of the best available evidence”, “EBM provides guidance to determine the level of confidence in estimates”, and “Evidence is never enough to drive clinical decision making.” Additionally, we identified 4 widely disseminated postulates: (1) Systematic reviews are at the top of the evidence pyramid, (2) randomized clinical trials are the best type of evidence, (3) expert opinion is a type of scientific evidence, and (4) to make health decisions, we should only use scientific publications. We critically assessed these postulates against scientific evidence and EBM principles, revealing them to be "myths." We identified f4 myths of EBM and proposed solutions to foster a more accurate interpretation and utilization of scientific evidence.
期刊介绍:
Educación Médica, revista trimestral que se viene publicando desde 1998 es editada desde enero de 2003 por la Fundación Educación Médica. Pretende contribuir a la difusión de los estudios y trabajos que en este campo se están llevando a cabo en todo el mundo, pero de una manera especial en nuestro entorno. Los artículos de Educación Médica tratarán tanto sobre aspectos prácticos de la docencia en su día a día como sobre cuestiones más teóricas de la educación médica. Así mismo, la revista intentará proporcionar análisis y opiniones de expertos de reconocido prestigio internacional.