Skip to main content


Log in

History and Development of Evidence-based Medicine

  • Published:
World Journal of Surgery Aims and scope Submit manuscript


This article illustrates the timeline of the development of evidence-based medicine (EBM). The term “evidence-based medicine” is relatively new. In fact, as far as we can tell, investigators from McMaster’s University began using the term during the 1990s. EBM was defined as “a systemic approach to analyze published research as the basis of clinical decision making.” Then in 1996, the term was more formally defined by Sacket et al., who stated that EBM was “the conscientious and judicious use of current best evidence from clinical care research in the management of individual patients.” Ancient era EBM consists of ancient historical or anecdotal accounts of what may be loosely termed EBM. This was followed by the development of the renaissance era of EBM, which began roughly during the seventeenth century. During this era personal journals were kept and textbooks began to become more prominent. This was followed by the 1900s, during an era we term the transitional era of EBM (1900–1970s). Knowledge during this era could be shared more easily in textbooks and eventually peer-reviewed journals. Finally, during the 1970s we enter the modern era of EBM. Technology has had a large role in the advancement of EBM. Computers and database software have allowed compilation of large amounts of data. The Index Medicus has become a medical dinosaur of the past that students of today likely do not recognize. The Internet has also allowed incredible access to masses of data and information. However, we must be careful with an overabundance of “unfiltered” data. As history, as clearly shown us, evidence and data do not immediately translate into evidence based practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1

Similar content being viewed by others


  1. J Ellis I Mulligan J Rowe et al. (1995) ArticleTitleInpatient general medicine is evidence based: A-team, Nuffield Department of Clinical Medicine Lancet 346 407–410 Occurrence Handle10.1016/S0140-6736(95)92781-6 Occurrence Handle7623571

    Article  PubMed  Google Scholar 

  2. DL Sackett WM Rosenberg (1995) ArticleTitleOn the need for evidence-based medicine Health. Econ. 4 249–254 Occurrence Handle8528427

    PubMed  Google Scholar 

  3. DL Sackett WM Rosenberg (1995) ArticleTitleThe need for evidence-based medicine J. R. Soc. Med. 88 620–624 Occurrence Handle8544145

    PubMed  Google Scholar 

  4. DL Sackett WM Rosenberg JA Gray et al. (1996) ArticleTitleEvidence based medicine: what it is and what it isn’t B.M.J. 312 71–72

    Google Scholar 

  5. GH Guyatt DL Sackett DJ Cook (1993) ArticleTitleUsers’guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group J.A.M.A. 270 2598–2601 Occurrence Handle8230645

    PubMed  Google Scholar 

  6. AD Oxman DL Sackett GH Guyatt (1993) ArticleTitleUsers’ guides to the medical literature. I. How to get started; the Evidence-Based Medicine Working Group J.A.M.A. 270 2093–2095 Occurrence Handle8411577

    PubMed  Google Scholar 

  7. Food in Daniel 1:1-16: the first controlled experiment? The James Lind Library ( Accessed February 10, 2004

  8. Gong Y, Gluud C. Commentary on the Ben Cao Tu Jing [Atlas of Materia Medica], 11th century. The James Lind Library ( Accessed February 10, 2004

  9. Oriatrike, or physick refined: the common errors therein refuted and the whole are reformed and rectified. London Lodowick-Loyd, 1662;526. Also avaliable at The James Lind Library ( Accessed February 10, 2004

  10. John Clark 1780 & 1792: learning from properly kept records. In: The James Lind Library ( Accessed February 10, 2004

  11. Milne I, Chalmers I. Hamilton’s report of a controlled trial of bloodletting, 1816.The James Lind Library ( Accessed February 10, 2004

  12. P Louis (1836) ArticleTitleResearches on the effects of blood-letting in some inflammatory diseases, and on the influence of tartarised antimony and visication in pneumonitis Am. J. Med. Sci. 18 102–111

    Google Scholar 

  13. PK Rangachari (1997) ArticleTitleEvidence-based medicine: old French wine with a new Canadian label? J R. Soc. Med 90 280–284

    Google Scholar 

  14. Louis-Dominique-Jules Gavarret (1809-1890). In: The James Lind Library ( Accessed December 9, 2003

  15. Woodall J. The surgeon’s mate, or military & domestique surgery. London, Rob, 1639

  16. Lind J. A Treatise of the Scurvy in Three Parts: containing an inquiry into the Nature, Causes and Cure of that Disease, Together with a Critical and Chronological View of What Has Been published on the Subject. London, 1753.

  17. The works of that famous surgeon Ambroise Paré. London: Mary Clark, 1678. In: The James Lind Library ( Accessed December 9, 2003

  18. Cheselden’s 1740 presentation of data on age-specific mortality after lithotomy. The James Lind Library ( Accessed February 10, 2004

  19. Edward Alanson 1782: responsibility in surgical innovation. In: The James Lind Library ( Accessed February 10, 2004

  20. E Alanson (1782) Practical Observations on Amputation, and the After-treatment EditionNumber2 Joseph Johnson London

    Google Scholar 

  21. SC Kaska JN Weinstein (1998) ArticleTitleHistorical perspective: Ernest Amory Codman, 1869–1940: a pioneer of evidence-based medicine: the end result idea Spine 23 629–633 Occurrence Handle10.1097/00007632-199803010-00019 Occurrence Handle9530796

    Article  PubMed  Google Scholar 

  22. E Passaro SuffixJr CH Organ SuffixJr. A Ernest (1999) ArticleTitleCodman: the improper Bostonian Bull .Am. Coll. Surg. 84 16–22 Occurrence Handle10345531

    PubMed  Google Scholar 

  23. A. A Donabedian Ernest MD Codman (1990) ArticleTitlethe end result idea and the product of a hospital: a commentary Arch. Pathol. Lab. Med. 14 1105

    Google Scholar 

  24. A Yoshioka (1998) ArticleTitleUse of randomization in the Medical Research Council’s clinical trial of streptomycin in pulmonary tuberculosis in the 1940s B.M.J. 317 1220–1223

    Google Scholar 

  25. J Amberson B McMahon M Pinner (1931) ArticleTitleA clinical trial of sanocrysin in pulmonary tuberculosis Am. Rev. Tuberc. 24 401–435

    Google Scholar 

  26. G Theobald (1937) ArticleTitleEffect of calcium and vitamin A and D on incidence of pregnancy toxaemia Lancet 2 1397–1399 Occurrence Handle10.1016/S0140-6736(00)83249-3

    Article  Google Scholar 

  27. InstitutionalAuthorNameHealth PsLo. (1946) ArticleTitleThe nutrition of expectant, nursing mothers in relation to maternal and infant mortality and morbidity J. Obstet. Gynaecol. Br. Emp. 53 498–509

    Google Scholar 

  28. InstitutionalAuthorNameHealth PsLo (1942) ArticleTitleNutrition of expectant and nursing mothers B.M.J. 2 10–11

    Google Scholar 

  29. A Cochrane (1941) ArticleTitleSickness in Salonica: my first, worst, and most successful clinical trial B. M. J. 289 1726–1727

    Google Scholar 

  30. JG Bartlett SF Dowell LA Mandell et al. (2000) ArticleTitlepractice guidelines for the management of community-acquired pneumonia in adults: Infectious Diseases Society of America Clin. Infect. Dis. 31 347–382 Occurrence Handle10.1086/313954 Occurrence Handle10987697

    Article  PubMed  Google Scholar 

  31. Trauma Practice Guidelines. 1998. (Accessed March 18, 2004, at

  32. Critical Care Guidelines. 2004. (Accessed March 18, 2004, at

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Timothy C. Fabian M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Claridge, J.A., Fabian, T.C. History and Development of Evidence-based Medicine. World J. Surg. 29, 547–553 (2005).

Download citation

  • Published:

  • Issue Date:

  • DOI: