Elsevier

The Lancet

Volume 346, Issue 8978, 23 September 1995, Page 785
The Lancet

EDITORIAL
Evidence-based medicine, in its place

https://doi.org/10.1016/S0140-6736(95)91610-5Get rights and content

References (0)

Cited by (121)

  • David Sackett was one of a kind

    2016, Journal of Clinical Epidemiology
  • Towards a person-centered medical education: challenges and imperatives (I)

    2015, Educacion Medica
    Citation Excerpt :

    For this reason, and to make progress towards the development of new clinical methods to deal far more effectively with the current epidemic of multi-morbid, socially complex long term illness, Miles and Asbridge have called for the “collapse” of the vertically ordered “Hierarchy of Evidence” of EBM into a horizontally ordered “Library of Clinical Knowledge Sources” which places scientific knowledge alongside all other forms of clinical knowledge of relevance to clinical decision-making and from which the wise clinician can draw, as indicated, with direct reference to the specific needs of the individual patient1–10. A science-informed versus science-based model of this type ensures that, as The Lancet insisted in 1995, EBM is positioned “in its place”36 — a place from which it directly informs and facilitates clinical practice without restricting decision-making, a position which allows reliable science to be integrated, if appropriate, with patients’ subjectively asserted needs. This model is person-centered medicine, “a philosophy and method which enables affordable biomedical and technological advance to be delivered to patients within a humanistic framework of care that recognizes the importance of applying science in a manner which respects the patient as a whole person and takes full account of his values, preferences, aspirations, stories, cultural context, fears, worries and hopes and thus which recognizes and responds to his emotional, social and spiritual necessities in addition to his physical needs”1–10.

View all citing articles on Scopus
View full text