The process of evidence-based medicine and the search for meaning.
OBJECTIVE
Evidence based medicine is the present backbone of rational and objective, modern medical problem solving and is a meeting ground for quantitative and qualitative researchers alike as it culminates into applying the fruits of clinical research to the individual patient. A systematic enquiry into the evolving paradigms in EBM is a need of the hour.


OBJECTIVE
A qualitative enquiry examining the impact of different methodologies in EBM and their role in generating meaning interpretable at individual levels.


RESULTS
Present day outcome based research deals less with patients as individuals than as populations. Evidence based medicine struggles to apply the fruits of population based research to individuals who are often not as predictable as linear quantitative research would like them to be. The present EBM literature neglects a lot of events it doesn't believe to be statistically significant and perhaps here is an area that needs to be improved on - it assumes that because associations are demonstrated between interventions and outcomes in RCTs/meta-analysis, these associations are linear and causal in the real world. While they may be demonstrated repeatedly in highly controlled environments, in the real 'uncontrolled' world of clinical practice with real people, their validity breaks down.


CONCLUSIONS
One needs to make the EBM standard model patient-individual (a projection of collective patient event data) resemble the real human individual patient so that optimal EBM individual data that matches our query can be easily and quickly spotted from the dense jungle of information that has grown over the years. This hints at rethinking our entire research methodology and modifying it to suit the needs of the individual patient.
Biswas
Rakesh
R
Department of Medicine, Melaka Manipal Medical College, Melaka, Malaysia. rakesh7biswas@gmail.com
Umakanth
Shashikiran
S
Strumberg
Joachim
J
Martin
Carmel M
CM
Hande
Manjunath
M
Nagra
Jagbir S
JS
D035843:Biomedical Research / Q000379:methods; D003657:Decision Making; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans