12. Moving EBM Forward

  1. Jeremy Howick1,2

Published Online: 23 MAR 2011

DOI: 10.1002/9781444342673.ch12

The Philosophy of Evidence-Based Medicine

The Philosophy of Evidence-Based Medicine

How to Cite

Howick, J. (2011) Moving EBM Forward, in The Philosophy of Evidence-Based Medicine, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444342673.ch12

Author Information

  1. 1

    Centre for Evidence-Based Medicine, Department of Public Health and Primary Care, University of Oxford, Oxford, UK

  2. 2

    Department of Science and Technology Studies, University College London, London, UK

Publication History

  1. Published Online: 23 MAR 2011
  2. Published Print: 8 APR 2011

ISBN Information

Print ISBN: 9781405196673

Online ISBN: 9781444342673



  • moving EBM forward - EBM requirement, systematic reviews of “best” research evidence informing clinical decisions, being uncontroversial;
  • EBM proponents, randomized trials - suffering from fewer confounders than observational studies;
  • paradox, resolved by replacing strict hierarchies - comparative clinical studies revealing an effect size outweighing combined effect of plausible confounders;
  • double masking, methodological virtue - ruling out confounders, unsuccessful masking causing effects;
  • EBM proponents, overlooking problems - plaguing mechanistic reasoning;
  • EBM advocates, warning against evidential value - of authoritative pronouncements, and expert judgment as reliable sources of knowledge;
  • EBM philosophy of evidence – implications, how treatments are appraised;
  • two new frontiers for EBM - new class of biases, becoming apparent;
  • industry-sponsored trials - with beneficial effects over non-industry funded trials;
  • robust methodologies, for EBM proponents - relative effects of options for overall health improvement


This chapter contains sections titled:

  • Summary of findings: the EBM philosophy is acceptable, but…

  • Two new frontiers for EBM

  • References