It might be pointed out that my critique of Evidence-Based Medicine is actually a straw man argument, insofar as EBM just represents an approach to evaluating and interpreting clinical research. But it is not the driving force behind clinical research. You might argue that what I am really taking to task is the “research enterprise”. That is the real adversary of my comments here pharmacieinde.fr. EBM is just a method for critically appraising such research.
This is partially true. Except that the effect of EBM is one of unintended consequences with regard to clinical research. Because EBM determines the criteria for what constitutes good research, it has had the unintended effect of significantly determining how most research is done. For example, if students assigned an essay are told that they will be evaluated primarily on their use of large, complicated words, you can be pretty sure that there will be a will be a copious proliferation of polysyllabic compositions. So it is with EBM. By determining the criteria for what constitutes good research, they determine in effect how the research will be done. It is an example of the tail of EBM wagging the dog of research. To some extent, and switching to a more religious analogy, you could say that EBM is like a deity which has created research in its own image.