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Theory. "We think that X comes from Y and the reasoning is ..." and then somebody else says the exact opposite, with an equally likely-sounding reasoning, and then you don't know what to do. "Evidence-based" means "shown to work - we may not know why, but at least it does".

On this topic, I recently realized the dangers in trying to propagate "evidence-based" throughout all sectors of healthcare. A nurse was complaining about a doctor questioning if a certain drug was safe for breast-feeding women (well for the child, actually). Indignantly, the nurse said "but this manual right here says it's safe! How much more evidence-based can it get!". To her, "the book says so" was "evidence". 'Evidence-based medicine' is no panacea - the principles maybe, but the hard part is in the implementation.



What's the alternative? Nurses don't trust manuals? Obviously as a society we should always strive for better science. But just like lady justice wears a blindfold, nurses should follow the manual.


Of course, that wasn't my point; my point is that when 'evidence based' becomes a mantra that is malunderstood by many, its use in inappropriate contexts devaluates the word and with that, the concept itself.




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