title: Evidence-based medicine in practice.
abstract: Evidence-based medicine (EBM) has emerged as a dominant paradigm in healthcare, strongly influencing clinical decision-making, access to and funding for interventions. However, EBM has a number of limitations, which appear to have been under-represented in the literature. We explore the development and shortcomings of EBM, and consider a complementary role for practice-based evidence in guiding clinical decision-making. EBM is a valuable and important part of the medical landscape. However, a range of significant limitations makes over-reliance on this paradigm problematic. Appropriate recognition of practice-based evidence helps to bridge the gap between evidence and clinical practices.
authors.affiliation: Hauora Waikato, Hamilton, New Zealand Waikato Clinical School, University of Auckland, Hamilton, New Zealand. rishi.duggal@hauorawaikato.org.nz
authors.forename: R
authors.initials: R
authors.lastname: Duggal
authors.forename: D B
authors.initials: DB
authors.lastname: Menkes
mesh_terms: D022126:Access to Information; D015982:Bias; D030881:Disclosure; D023381:Endpoint Determination; D019317:Evidence-Based Medicine; D006801:Humans; D007258:Informed Consent; D011364:Professional Practice; D012107:Research Design