The hard art of soft science: Evidence-Based Medicine, Reasoned Medicine or both?

Authors

  • Milos Jenicek MD PhD FRCPC

    Corresponding author
    1. Professor, Department of Clinical Epidemiology and Biostatistics at McMaster University, Hamilton, Ontario, Canada
    2. Professor Emeritus, Université de Montréal, Montréal, Québec, Canada
    3. Adjunct Professor at McGill University, Montréal, Québec, Canada
      Dr. Milos Jenicek
      Department of Clinical Epidemiology and
      Biostatistics
      McMaster University
      Hamilton
      Ontario Canada
      E-mail: jenicekm@mcmaster.ca.
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Dr. Milos Jenicek
Department of Clinical Epidemiology and
Biostatistics
McMaster University
Hamilton
Ontario Canada
E-mail: jenicekm@mcmaster.ca.

Abstract

In the past 14 years, Evidence-Based Medicine (EBM) has enjoyed unprecedented developments and gained widespread acceptance among health professionals. However, should we be content with producing, critically appraising and using the best evidence available for our understanding of health problems and decision making about them? Are our convictions about EBM’s relevance, our conviction and intellectual satisfaction with its mastery and adoption enough? Should we continue pushing forward along this promising path, or should we further diversify the content and scope of EBM? Is EBM the only way to view medicine in the near future? This paper presents some options to choose from in terms of direction and content as well as questions to answer given the current EBM crossroads. More intensive and extensive EBM combined with ‘other features’-based medicines may be the preferred strategy to follow in the future to determine the development, use and evaluation of EBM. Argument-based medicine or Reasoned Medicine is one of the options that can be integrated into the mainstream of medical reasoning and decision making.

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