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Death of EBM?

It is seven years since the idea of a monthly bulletin of bullet points of evidence Bandolier first started to take shape in November 1993. Since February 1994 there have been 81 issues of Bandolier and 10 issues of ImpAct . There have been about 1.8 million copies of Bandolier and ImpAct printed. A total of about 700,000 words have been written. People are now visiting the Internet site at a rate of over 80,000 a week, or 4 million a year, and the rate of growth is phenomenal.

Death of EBM?

The death of evidence-based medicine has been greatly exaggerated. People still have problems in getting to grips with what it's all about. This includes enthusiasts as well as critics. Kenneth Tynan once described a critic as someone who knows the way but can't drive the car. But an inability to understand fully how use of evidence is mutually beneficial affects critics and enthusiasts both.

Better evidence better used

One recent example was a researcher from a pharmaceutical company who asked 'What is an NNT?' of an audience skilled in their use. Healthcare companies persist in making information about products more, rather than less, obscure. They are not learning, and that is to the detriment of the whole community. There are too many examples, like treatments for Alzheimer's disease, where better analysis of available clinical trial information would probably make decision making easier at all levels. We could do with some cooperation.

As common are the enthusiasts and critics who latch on to some of the more obscure issues, like funnel plots, to dismiss systematic reviews and meta-analysis because it suits when budgets are tight. We show why this is wrong in this issue , as well as show how the growth in evidence-based knowledge can improve healthcare.

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