Journal Club: Progress in Evidence-Based Medicine: A quarter century on

Meeting date: Tuesday, November 20, 2018

Presenter: Lukas Miller

Citation: Djulbegovic, B., & Guyatt, G.H. (2017). Progress in evidence-based medicine: a quarter century on. Lancet, 390(10092), 415-423. doi:

Article abstract:

In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM’s initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient’s values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM’s enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations.

Critical Appraisal: 

Note: Gordon Guyatt is considered the originator of the concept of evidence-based medicine.

1. Can you relate to any changes to librarianship (health/medical or otherwise) that coincide with the author’s observations of EBM’s own evolution?
2. BD and GHG provide a prediction for the next 25 years based upon their review. Given their predictions, how do you think libraries must adapt to meet the needs of evidence-based research & practice?
3. Did you learn something new, or has your perspective on evidence-based medicine changed in any way after reading this article? If yes, how might it affect your practice? Will this help you teach/explain EBM?
4. [If time, open discussion]

Completed Critical Appraisal Summary