Evidence-based medicine – are we boiling the frog?

David James Jackson Muckart


Evidence-based medicine has been defined as ‘The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.’ There are two major assumptions in this statement. First, it is assumed that the evidence is in fact the best. Unfortunately this is not necessarily so, and published evidence is affected by bias, sponsorship, and blind faith in mathematical probability which may not be clinically relevant. Second, the evidence is population based and may not be applicable to the individual, and blind adherence to this concept may cause harm. We must not abandon clinical experience and judgement in favour of a series of inanimate data points. Medicine is an uncertain science. 

Author's affiliations

David James Jackson Muckart, Associate Professor of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Chief Specialist, Level I Trauma Unit and Trauma Intensive Care Unit, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

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Evidence-based medicine; clinical practice

Cite this article

South African Medical Journal 2013;103(7):447-448. DOI:10.7196/SAMJ.6805

Article History

Date submitted: 2013-05-15
Date published: 2013-05-28

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