Thorp, John M., Jr. (2008). Synthesize Evidence and They Will Change?. American Journal of Obstetrics & Gynecology, 199(5)
Evidence-based medicine (EBM) is an outgrowth of the 20th century Western world's embrace of modernity based on the belief that by compiling, categorizing, synthesizing, and grading the medical literature the wisdom accumulated in the synthesis would move medical practice away from its anecdotal and traditional roots into a golden age of rationalism. Clinicians guided by evidence reports, metaanalyses, and quality grades would experience the benefits of the enlightenment and embrace the progress and improvement inherent in modernity. Implicit in this sequence is an untested assumption (quality grade of “poor,” recommendation = I) that physicians would desire to modernize their practice, and furthermore, inherent within the accumulation and cataloguing of evidence would be the motivation to change their behavior. This is analogous to the assumption in the movie, Field of Dreams, where the builder of a baseball stadium in the middle of a cornfield in rural Iowa repeatedly claims, “build it and they will come.”1 Berghella et al work within this paradigm and the untested assumptions of EBM and provide readers with an excellent summation of evidence-based intrapartum care.2 Despite the quality and thoroughness of their work, the question remains—is EBM effective at improving physicians' practice?
American Journal of Obstetrics & Gynecology
Thorp, John M., Jr.