Data (i.e., evidence) about evidence-based medicine: slideshow
Click on any of the thumbnails below to open the slideshow and read the captions for each one of these figures.
Evidence based medicine is not evidence based. There is no data (i.e., evidence) supporting the hierarchical levels of evidence, provided by different types of human studies, since the first papers of EBM published by journals indexed in PubMed (1992). This graph also shows a descending trend in the scientific output of EBM papers.
This figure (one week-periods) confirms the descending trend of EBM scientific output.
PubMed publication delay in the indexation processes does not explain the descending trends in the scientific output of evidence-based medicine.
Descending trends (Google Search Terms — EBM)
1. More descending trends (Google Search Terms — EBM) 2. The concept of EBM is also geographically limited (US, Canada, UK, Australia, Colombia, Argentina, Chile, Mexico, Spain).
Google trends: “medicina basada en la evidencia” (Spanish — Evidence Based Medicine).
1. Evidence Based Medicine 2. Medicina Basada en la Evidencia 3. EBM 4. Practice guidelines 5. Médecine Factuelle
More than 12 citations in average per article. But, it have to be considered that: 1. Not all articles are cited or. 2. Some articles receive a large number of citations (over 500-2000 citations). And… (number 3 follows)
(not a good example of the correct appraisal of scientific evidence) — Note: number 6 is a good example of the opposite (good appraisal of the evidence). Here is the list (1 to 50). The database (500 most cited EBM papers) is available in this URL: http://dx.doi.org/10.6084/m9.figshare.1247137
Over half remains hidden (unpublished) and sometimes data has been destroyed (e.g., fluxetine trial).
Chaos theory to Evidence-Based Medicine: Good Bye!
Top 10 Phase 3 Clinical Trials: Number of changes in the study protocol.
Collapsing… the pyramid of EBM will not last long… In fact (next slide)
“You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” ― Buckminster Fuller — To be continued…
Ramirez, Jorge H (2014): Data (i.e., evidence) about evidence-based medicine. figshare. http://dx.doi.org/10.6084/m9.figshare.1093997
Evidence Live 2015: Hierarchical levels of evidence based medicine are incorrect
Evidence Live 2015: Analysis of US phase 3 ClinicalTrials.gov records completed before January 1st, 2011 (n=5051; time frame: 2002 to 2014)