A Popperian perspective of the term 'evidence-based medicine'.
If the term 'evidence-based medicine' conveys more than is conveyed by the word medicine, then there must be a way to distinguish between evidence-based medicine and non-evidence-based medicine. In particular, there must be a logically acceptable way to classify medical decisions as justified or unjustified by scientific evidence. In this essay I examine the nature of medical theories, the nature of the evidence that is produced by empirical tests of medical theories, and the relation of medical decisions to both. I conclude that attempts to classify medical decisions as justified or unjustified by scientific evidence have no foundation in logic and that the term 'evidence-based medicine' is logically indistinguishable from the term 'medicine'. The use of the term 'evidence-based medicine' calls for a new type of authoritarianism in medical practice.
Shahar
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Division of Epidemiology, University of Minnesota, Minneapolis 55454-1015, USA.
D001318:Authoritarianism; D003627:Data Interpretation, Statistical; D003661:Decision Support Techniques; D019348:Empiricism; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D006801:Humans; D015203:Reproducibility of Results; D012586:Science