Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). Within Western countries, EBM has grown in importance in the clinical arena as a mechanism to eliminate the over- or under-use of medical services and thus to maximize efficient care (Sackett et al., 2000). Few anthropologists have begun to explore the cultural values underpinning both the reliance on randomized clinical trials to inform health policy, and health professionals' resistance to implementing such guidelines into clinical practice (Bogdan-Lovis, 2001; Gordon, 2003b). Ethically, EBM raises questions about macro-allocation in the provision of quality care because health insurance plans increasingly depend on EBM guidelines to determine which problems receive coverage (Hope, 1995). Since EBM has become integrated into medical education, future research could investigate shifts in medical knowledge (epistemology) and concomitant changes in clinical practice by, for instance, investigating how physicians negotiate between drawing on population-based data (consistent with the goals of public health) and drawing on the knowledge and preferences of individual patients (consistent with the traditional goals of medicine and ethics) (Tonelli, 1998). Thus, research in EBM is a fertile area that entails the intersection of cultural studies of science, decision-making, and health policy.
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