Examining the assumptions of evidence‐based medicine

Evidence-based medicine (EBM) has had enormous impact on clinical medicine, attracting both converts and detractors. The basic premise, that clinical decisions should be made on evidence which is as sound as possible, appears unassailable. Why, then, has the idea stimulated such controversy? In this article, I examine six assumptions of EBM, and point out how these assumptions are frequently open to challenge. Finally, I make specific …