The myth of Evidence Based Practice

The title might as well have been: The Holy Grail of health care. With a devotion worthy of a Knight of the Cross EBM disciples worshipped and defend one single method of research (the randomized controlled trial) as the one and only truth bringing research. The significance of the research topic, the why of the results and even the relation with reality are made totally subordinated to results that can be caught in statistics. Another strange distortion of reality caused by overly focused use of EBM is the negative burden of proof: something cannot be true, unless proven by EBM standards. Natural events will have to be EBM proven to be true. It is as for yet to be seen if natural green grass indeed will turn hay-colored in dry-hot periods. In the same way breastfeeding seems to need to be proven as well. And of course it can't: how would one conduct a double blind and (ethically sound) randomized, controlled trial to prove differences between breastfeeding and bottle feeding? Between short- and long-term breastfeeding or between exclusive and non-exclusive breastfeeding? And so everything that is said about breastfeeding can’t possibly be true. Historical and anthropological research and plain logic reasoning obviously will not suffice in believing that centuries of evolution will have led to a well-working system. Well, the knights didn’t ever find the grail either, did they? Perhaps Dan Brown’s Da Vinci Code deductions are true after all?
Tobin MJ: Counterpoint: Evidence-Based Medicine Lacks a Sound Scientific Base. CHEST, 2008, 133(5):1071-1074
Ater G: Statistics can say whatever you want, but not necessarily the “why?” http://commonsense-gater.blogspot.com/2010/11/statistics-can-say-whatever-you-want.html Monday, November 1, 2010