Evidence-based medicine and the real world: understanding the controversy

Controversy has surrounded the 'paradigm' of evidence-based medicine since its introduction in 1992 as a new approach to the teaching and practice of medicine. Here, we address two questions: (1) is evidence-based medicine a good thing?; and (2) why has so much controversy arisen? In addressing thes e questions, we propose that the discussion surrounding evidence-based medi cine should no longer be about whether the application of evidence in clini cal practice is a good thing, because it obviously is. Instead, the debate ought to focus on the more difficult question of how to enhance its accepta bility among busy clinicians practising in the 'real world'. For the future , we optimistically anticipate an enhanced adoption of evidence-based medic ine, as clinicians will become increasingly capable of efficiently accessin g existing and forthcoming evidence resources.