Int J Med Sci 2018; 15(12):1397-1405. doi:10.7150/ijms.25869


The Emperor's New Clothes: a Critical Appraisal of Evidence-based Medicine

Giovanni D. Tebala

East Kent Hospitals University, William Harvey Hospital, Ashford, Kent, United Kingdom

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Tebala GD. The Emperor's New Clothes: a Critical Appraisal of Evidence-based Medicine. Int J Med Sci 2018; 15(12):1397-1405. doi:10.7150/ijms.25869. Available from

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Evidence-Based Medicine (EBM) is the way we are expected to deliver our healthcare in the 21st century. It has been described as the integration of information from best available evidence with the doctor's experience and the patient's point of view. Unfortunately, the original meaning of EBM has been lost and the worldwide medical community has shifted the paradigm to Guidelines-Based Medicine, that has displaced the figures of the doctor and the patient from the decision-making process and relegated them to mere executor and final target of decisions taken by someone else. Problems related to the reliability of evidence and to the way guidelines are constructed, implemented and followed are discussed in detail. It is mandatory that the whole medical community takes responsibility and tries to reverse this apparently inexorable process so to re-establish a proper evidence-based care, where patients and their healing relation with practitioners are at the centre and where doctors are able to critically evaluate the available evidence and use it in light of their personal experience and knowledge.

Keywords: evidence-based medicine, guidelines, healthcare