BACKGROUND: An evidenced-based approach to psychiatry is playing an increasingly prominent role in treatment decision-making for individual patients and for populations. Many doctors are now critical of the emphasis being placed on "the evidence" and concerned that clinical practice will become more constrained. AIMS: To demonstrate that evidence-based medicine is not new, sources of evidence are limited and psychosocial aspects of medicine are neglected in this process. METHOD: Some of the literature is reviewed. Ideas and arguments are synthesised into a critical commentary. RESULTS: These are considered under four headings: evidence-based medicine is not new; what evidence is acceptable; the doctor as therapist; and the emergence of a new utilitarian orthodoxy. CONCLUSIONS: It is agreed that a degree of professional consensus is necessary. However, too great an emphasis on evidence-based medicine oversimplifies the complex and interpersonal nature of clinical care.
BACKGROUND: An evidenced-based approach to psychiatry is playing an increasingly prominent role in treatment decision-making for individual patients and for populations. Many doctors are now critical of the emphasis being placed on "the evidence" and concerned that clinical practice will become more constrained. AIMS: To demonstrate that evidence-based medicine is not new, sources of evidence are limited and psychosocial aspects of medicine are neglected in this process. METHOD: Some of the literature is reviewed. Ideas and arguments are synthesised into a critical commentary. RESULTS: These are considered under four headings: evidence-based medicine is not new; what evidence is acceptable; the doctor as therapist; and the emergence of a new utilitarian orthodoxy. CONCLUSIONS: It is agreed that a degree of professional consensus is necessary. However, too great an emphasis on evidence-based medicine oversimplifies the complex and interpersonal nature of clinical care.
Authors: Robert C Smith; Catherine Lein; Clare Collins; Judith S Lyles; Barbara Given; Francesca C Dwamena; John Coffey; AnneMarie Hodges; Joseph C Gardiner; John Goddeeris; C William Given Journal: J Gen Intern Med Date: 2003-06 Impact factor: 5.128