Impact of EBM on Research

You may be inclined to think that problems in Clinical research are not the domain of Evidence-based Medicine, since EBM is just a series of techniques for evaluating the quality of clinical research. But, as I mentioned in the section on EBM and Geocentrism, over the years EBM has evolved from a methodology about how to evaluate evidence into a methodology about how to create and manage evidence. Because it determines what constitutes good evidence, EBM has had the unanticipated result of determining how clinical research is done. It is analogous to the situation that students writing essays might find themselves in, if they are told in advance that the primary criteria for grading their papers will be the use of large, complicated words.  One can pretty sure that there will be a copious proliferation of polysyllabic compositions. And so it is with EBM.  By establishing the criteria for what constitutes good evidence, it has determined how clinical research is done. It is a classic example of the tail EBM that is now wagging the dog of medical research.