Evidence based medicine overviews, bulletins, guidelines, and the new consensus

Competent clinical practice is necessarily based on good scientific evidence of effectiveness. Few would argue with this justification of “evidence based medicine” (EBM) and the best, most appropriate clinical interventions and therapies have probably always been based on the most relevant available evidence. So, we may ask, why is EBM a new idea. The “syndrome” has a multiple epidemiology. Explanations lie with the profusion of evidence, rate of accrual of new evidence (including contradictory evidence), changes in means of storing, retrieving, and disseminating evidence, and the increasing pressure on healthcare professionals from both government and the public to ensure that clinical practice is based on evidence. The present paper reviews this rapidly expanding “industry” of secondary research, which summarises the findings of primary studies and trials and packages the synopses for easy assimilation by busy practitioners and managers, and discusses some of its advantages, disadvantages, and possible consequences.