Visus writes: Doubts cast on evidence-based optometry

We are all encouraged to embrace evidence-based medicine but a recent paper has cast a light into the shadows suggesting that all may not as we might think. Grenhalgh et al¹, a group embedded in EBM, have called for a re-appraisal of its methods and benefits. Of course there have been critics of EBM such as the humorous Smith & Pell² who suggested that without randomised controlled trials of parachutes, the most radical proponents of EBM should participate in a double blind, randomised, placebo controlled, crossover trial! This is different.

Greenhalgh et al discuss examples where EBM has benefitted patient care citing the British Thoracic Society asthma guidelines. On the other hand they argue that the volume of evidence available is frequently unmanageable and statistically significant benefits can be marginal in clinical practice. No doubt the opposite may also be true where clinical experience is not advocated because of a lack of evidence at a high enough level.