Evidence Based? Caveat Emptor!

Abstract
Medical practices, clinical practice guidelines, clinical performance measures and measurements, and a variety of health care–related administrative decisions, such as insurance coverage decisions, are claiming to be “evidence based” with increasing frequency. In this paper we examine the “evidence based” label; discuss how evidence ought to have been assembled, evaluated, and synthesized; and when evidence is sufficient for the “evidence-based” moniker to rightfully apply. We also highlight several considerations other than the strength of evidence that are relevant to several common types of health care–related administrative decisions and that influence the extent to which the resulting decisions are truly evidence based.
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