EVIDENCE-BASED MEDICINE

Making judgments in science is an intricate process. Our decisions are formed by theoretical reasoning, extrapolation from empirical data, traditional conventions, and, often, local authorities. Most modern philosophers of science recognize that the old view of the scientific method as a totally unbiased approach to the interpretation of raw data is naive. All the data we collect in any experiment is created, selected, and interpreted within the context of our theory-based view of the world. Furthermore, more than one theoretical explanation can generally be given for any one set of data. All this being the case, it must still be stressed that modern medicine has passed from the era when "practice" and "art" were sufficient justification for medical decision making. Evidence-based medicine is the fashionable term for the approach to medical decision making in which careful use is made of the applicable experimental scientific data. Controlled clinical trials and large-scale observational studies are important methods for this approach. A meta-analysis is a report of data that combines results from multiple similar studies to create a statistically more powerful study with many more data points and a better opportunity to come to a statistically significant conclusion.

The practicing clinician has many sources that analyze empirical evidence and provide guidance for medical decisions. Governmental groups and private medical organizations have produced many guidelines and clinical practice documents that assess the quality of available evidence and make suggestions. To give further guidance, these suggestions may also be ranked by confidence. The most reliable data backed by well-established theories would give recommendations with the greatest weight. Reports that are backed by weaker data such as uncontrolled studies give recommendations with less confidence in the evidence.