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In this theme issue we ask how the evolution of evidence based medicine (EBM) has made a difference to the way we practice medicine and whether it has improved care for patients. So what is the evidence so far? The material we have collected shows that the answer is not straightforward, and it is still early days to be definitive about the success of the EBM movement. However, we hope this issue will fuel the debate by reflecting on the progress that has been made in practising and teaching EBM over the last 10 years and by drawing attention to those areas with which we continue to struggle.
EBM is now an integral part of many undergraduate, postgraduate, and continuing education activities. 1 â[euro]" 4 Coomarasamy and Khan identified 23 studies of educational interventions involving EBM in the postgraduate environment and found that clinically integrated teaching improved knowledge, skills, attitudes, and self reported behaviours ( p 1017 ). 2 Teaching EBM is also being incorporated successfully into journal club environments, with positive effects on changing practice and improving the care of patients. 4
Accurate, accessible, and continually updated sources of evidence such as the Cochrane Library and Clinical Evidence are now available widely, and freely to some middle and low income countries. Garner et al outline how sources such as the Cochrane Library are being used in a collaborative effort to translate evidence into practice in middle and low income countries. 5 Perhaps as important as identifying where evidence exists, sources of evidence also highlight gaps in the evidence that inform the focus of future research.
Sceptics would argue that producing research is one thing but showing that it...