Evidence-based - History

History

Traces of evidence-based medicine's origin can be found in ancient Greece. Although testing medical interventions for efficacy has existed since the time of Avicenna's The Canon of Medicine in the 11th century, it was only in the 20th century that this effort evolved to impact almost all fields of health care and policy.

In 1967, the American physician and mathematician Alvan R. Feinstein published his groundbreaking work Clinical Judgment, which together with Archie Cochrane’s famous book Effectiveness and Efficiency (1972) led to an increasing acceptance of clinical epidemiology and controlled studies during the 70s and 80s and paved the way for the institutional development of EBM in the 90s. Cochrane's efforts were recognized by the fact that an international network for efficacy assessment in medicine - the Cochrane Collaboration – was posthumously named after him. However, Cochrane himself did not live to see the foundation and institutionalization of the EBM movement and Feinstein became later in his life one of its sharpest methodological critics.

The explicit methodologies used to determine "best evidence" were largely established by the McMaster University research group led by David Sackett and Gordon Guyatt. Guyatt later coined the term “evidence-based” in 1990. The term "evidence-based medicine" first appeared in the medical literature in 1992 in a paper by Guyatt et al. Relevant journals include the British Medical Journal's Clinical Evidence, the Journal Of Evidence-Based Healthcare and Evidence Based Health Policy. All of these were co-founded by Anna Donald, an Australian pioneer in the discipline.