Will COVID-19 be evidence-based medicine’s nemesis?

Abstract

Once defined in rhetorical but ultimately meaningless terms as "the conscientious, judicious and explicit use of current best evidence in making decisions about the care of individual patients" [1], evidence-based medicine rests on certain philosophical assumptions: a singular truth, ascertainable through empirical enquiry; a linear logic of causality in which interventions have particular effect sizes; rigour defined primarily in methodological terms (especially, a hierarchy of preferred study designs and tools for detecting bias); and a deconstructive approach to problem-solving (the evidence base is built by answering focused questions, typically framed as 'PICO'-population-intervention-comparison-outcome)

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