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The Evolution of Evidence Based Clinical Medicine

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Practical Pediatric Urology

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Abstract

It’s over quarter-century since the working group chaired by Gordon Guyatt introduced evidence-based medicine (EBM) as a ‘new paradigm for medical practice’ and 35 years since the foundations of evidence-based medicine were established by David Sackett. EBM has transformed medical decision making and practice in the last quarter century. EBM was established to define what constitutes acceptable evidence, namely, that which is scientific rather than personal. Defined as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’, Sackett proposed that EBM considered the best available evidence, clinical skills and the patient’s situation and expectations. The popularity and adoption of EBM has led to globally established systems to review medical evidence that include the Cochrane Collaboration, the Oxford Centre for Evidence Based Medicine an established approach to the evaluation of clinical evidence proposed in 2000, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE). However, some have challenged the reliance on EBM, suggesting that the evidence generated is overly generalisable, is limited to treatment-efficacy and does not account for other attributes and issues relating to interventions, and that it is open to exploitation. The following chapter describes the rise and development of EBM, the systems established to review medical evidence and the criticisms that have evolved.

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Author information

Authors and Affiliations

  1. Sheffield Children’s NHS Foundation Trust, Sheffield, UK

    Paul Dimitri

  2. Sheffield Hallam University, Sheffield, UK

    Paul Dimitri

  3. University of Sheffield, Sheffield, UK

    Paul Dimitri

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  1. Paul Dimitri
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Correspondence to Paul Dimitri .

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Editors and Affiliations

  1. Department of Paediatric Surgery, Sheffield Children’s Foundation Trust, Sheffield, UK

    Prasad Godbole

  2. Division of Urology, University of Colorado Division of Urology, Aurora, CO, USA

    Duncan T. Wilcox

  3. Department of Surgery and IHPME, University of Toronto Paediatric Urology, The Hospital for Sick Children, Toronto, ON, Canada

    Martin A. Koyle

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Dimitri, P. (2021). The Evolution of Evidence Based Clinical Medicine. In: Godbole, P., Wilcox, D.T., Koyle, M.A. (eds) Practical Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-54020-3_1

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  • DOI: https://doi.org/10.1007/978-3-030-54020-3_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-54019-7

  • Online ISBN: 978-3-030-54020-3

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