The History of EBM
The concepts embodied in the vision of Evidence Based Clinical Practice emerged at the end of seventies when a group of clinical epidemiologists of McMaster University, under the leadership of David Sackett, Brian Haynes, Peter Tugwell and Victor Neufeld, planned a series of articles describing basic rules for clinicians to critically analyze scientific evidence. The series was published in the beginning of 1981 in the Canadian Medical Association Journal and was framed around critical analysis of articles pertaining to therapy, diagnosis and etiology and causation. Also during the 1980’s, Brian Haynes spurred developments in informatics and information retrieval that led to what we now enjoy as a rich array of electronic resources that allow clinicians to access appraised and synopsized clinical evidence in ways that meet the time-pressed needs of clinical practice. In the nineties, Dr Gordon Guyatt, contining Sackett’s work, introduced the concept of evidence based clinical practice as an essential aspect of training in the health professions. The approach eventually came to embrace multiple disciplines, among them medicine, nursing, physical therapy, nutrition and dental care.
Concepts pertinent to such training have been developed and disseminated by Drs Sacket, Guyatt and others at McMaster University over the last 30 years through international workshops based on small group learning. Such approaches have been adopted in many training programs in North America and elsewhere. Our proposal aims to instill critical thinking that can be applied systematically to graduate and post-graduate programs, to the implementation of quality improvement programs, to health technology assessments and to guideline development.