The term evidence-based medicine has been defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”1(p71) Few other concepts in contemporary medical practice have achieved such universal adulation among practitioners, academicians, and payers. As a profession, we have placed evidence-based medicine on a golden pedestal as the ultimate expression of our desire to make clinical decisions in a systematic and scientific fashion. In an ideal world, evidence-based medicine drives the content of clinical guidelines and informs decisions by payers about what tests or procedures should be performed and reimbursed. In developing guidelines, authors typically integrate the findings from all available published studies to provide the best possible advice to clinicians. Accordingly, the quality of guidelines is only as good as the published studies on which they are based.
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