Trickle down evidence-based medicine to evidence-based medicine

Keynote speaker: Victor Montori

Keynote session: Evidence-based medicine (EBM) is often framed as a cascade: better evidence leads to better care. Evidence that responds to research or industrial priorities is produced. Then, efforts are mobilized to resolve gaps in evidence translation. However, care, and therefore evidence-based medicine, is about resolving the problematic human situation of patients, not the efficient translation of evidence into practice. Rather than trickling down, trustworthy evidence must be developed to respond to the problems that bubble up from care. This evidence must then be made readily and fully available so that clinicians and patients can carefully draw from it to develop care that makes intellectual, emotional and practical sense.