The scientific basis of evidence-based medicine (EBM) rests on three principles. First, systematic summaries of the highest quality available evidence should inform clinical decisions. Second, wise use of the literature requires a sophisticated hierarchy of evidence. Finally, evidence alone is never sufficient to make clinical decisions; rather, it requires trading off benefits and risks, inconvenience, and costs, and in doing so considering patients' values and preferences.
1Antman, E, Lau, J, Kupelnick, B, et al (1992) A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts: treatments for myocardial infarction.JAMA268,240-2482Guyatt, GH, Gutterman, D, Baumann, MH, et al Grading strength of recommendations and quality of evidence in clinical guidelines.Chest2006;129,174-1813Guyatt, GH, Sackett, DL, Taylor, DW, et al Determining optimal therapy: randomized trials in individual patients.N Engl J Med1986;314,889-8924Kunz, R, Oxman, A The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trials.BMJ1998;317,1185-11905Lacchetti, C, Ioannidis, J, Guyatt, GH Surprising results of randomized trials: users' guides to the medical literature; a manual of evidence-based clinical practice2001,247-269 AMA Press. Chicago, IL: 6Doroshow, J, Locker, G, Ifrim, I, et al Prevention of doxorubicin cardiac toxicity in the mouse by N-acetylcysteine.J Clin Invest1981;68,1053-10647Unverferth, D, Jagadeesh, J, Unverferth, B, et al Attempt to prevent doxorubicin-induced acute human myocardial morphologic damage with acetylcysteine.J Natl Cancer Inst1983;71,917-9208Faden, A, Jacobs, T, Holaday, J Opiate antagonist improves neurologic recovery after spinal injury.Science1981;211,493-4949Bracken, M, Shepard, M, Collins, W, et al A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury: results of the Second National Acute Spinal Cord Injury Study.N Engl J Med1990;322,1405-141110Echt, D, Liebson, P, Mitchell, L, et al Mortality and morbidity in patients receiving encainide, flecainide, or placebo: the Cardiac Arrhythmia Suppression Trial.N Engl J Med1991;324,781-78811Mason, J, Peters, F Antiarrhythmic efficacy of encainide in patients with refractory recurrent ventricular tachycardia.Circulation1981;63,670-67512Rossaint, R, Falke, K, Lopez, F, et al Inhaled nitric oxide for the adult respiratory distress syndrome.N Engl J Med1993;328,399-40513Taylor, R, Zimmerman, J, Dellinger, R, et al Low-dose inhaled nitric oxide in patients with acute lung injury: a randomized controlled trial.JAMA2004;291,1603-160914Flaherty, K, Kazerooni, E, Curtis, J, et al Short-term and long-term outcomes after bilateral lung volume reduction surgery: prediction by quantitative CT.Chest2001;119,1337-134615National Emphysema Treatment Trial Research Group.. Patients at high risk of death after lung-volume-reduction surgery.N Engl J Med2001;345,1075-108316Rosenqvist, M, Brandt, J, Schuller, H Long-term pacing in sinus node disease: effects of stimulation mode on cardiovascular morbidity and mortality.Am Heart J1988;116,16-2217Connolly, S, Kerr, C, Gent, M, et al Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes: Canadian Trial of Physiologic Pacing Investigators.N Engl J Med2000;342,1385-139118Knox, J, Wilmore, D, Demling, R, et al Use of growth hormone for postoperative respiratory failure.Am J Surg1996;171,576-58019Takala, J, Ruokonen, E, Webster, N, et al Increased mortality associated with growth hormone treatment in critically ill adults.N Engl J Med1999;341,785-79220Tonelli, M The limits of evidence-based medicine.Respir Care2001;46,1435-144021Guyatt, G, Haynes, R, Jaeschke, R, et al Users' guides to the medical literature: xxv. Evidence-based medicine: principles for applying the users' guides to patient care.JAMA2000;284,1290-129622Devereaux, P, Anderson, D, Gardner, M, et al Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study.BMJ2001;323,1218-122223O'Connor, A, Legare, F, Stacey, D Risk communication in practice: the contribution of decision aids.BMJ2003;327,736-74024Mermel, LA Prevention of intravascular catheter-related infections.Ann Intern Med2000;132,391-40225Pronovost, P, Needham, D, Berenholtz, S, et al An intervention to decrease catheter-related bloodstream infections in the ICU.N Engl J Med2006;355,2725-2732