What does 'Evidence-Based Medicine' (EBM) mean?
EBM refers to making recommendations based on good, solid data. NOT on case histories, anecdotal evidence, or even professional opinion and experience. CERTAINLY not on folk lore, folk wisdom, and traditional healing methods - at least, until they're proven to work.
There are several kinds of evidence we look at to decide whether a preventive measure or therapy works effectively. These include studies of populations, biochemical mechanisms, and studies that show a benefit of the intervention. However, these don't prove that the preventive or therapeutic measure works.
'Proven to work' means, in the eyes of the scientific community, doing what are called randomized, double-blind, placebo-controlled clinical trials. The more, the better.
How will the EBM concept be used on this site? When we search for information for you, we will be looking to find the most current AND the most convincing evidence of a therapy's effectiveness. We'll start with the controlled clinical trials, and then look at all the other types of studies available (except animal research). If there are several types of evidence available but no clinical trials, we'll let you know that the evidence is not particularly strong. However, if all other data support a benefit and only small clinical trials have shown benefit, we'll suggest appropriate caution. Evidence grades (A to D) will be used.
GRADE 'A' Evidence: Several randomized, double-blind, placebo-controlled clinical trials by independent researchers (not those who are paid by the companies who manufacture treatments being investigated); accompanied by other forms of evidence (observational studies, cohort studies, cross-sectional studies, case-control studies, and large epidemiological studies such as the Health Professionals Study, EPIC, etc).
GRADE 'B' Evidence: At least one double-blind, placebo-controlled clinical trial; open clinical trials or those with less strict criteria; in addition to other forms of evidence noted above.
GRADE 'C' Evidence: Epidemiological evidence from large studies (the Health Professionals Study, EPIC, etc); smaller epidemiological studies, case-control studies, ecological studies, basic (lab) research.
GRADE 'D' Evidence: Smaller epidemiological and case-control studies; case studies; basic research; anecdotal evidence; traditional use of product or service
