Evidence-based medicine and traditional, complementary, and integrative medicines: an unfinished agenda

Evidence-based medicine (EBM) has contributed to scientifically update diagnostic and therapeutic decisions. However, its application to traditional, complementary and integrative medicine (TCIM) faces challenges, especially in primary health care (PHC). This essay analyzes problems in the application of EBM to TCIM in PHC. It argues against the tendency to limit such application to the assessment of the methodological quality of quantitative evidence. It defends the insufficiency/inadequacy of EBM as the sole criterion for validating TCIM in PHC, the need to consider the complexity of some of these practices and the full application of EBM, integrating critical evaluation of the best scientific evidence, professionals' experience, users' preferences/values, and care circumstances - consensual pillars of EBM that have not been applied in a balanced way. Thus, EBM would be better used in integrating TCIM into health care in PHC.