I think of EBM as "where stronger evidence exists it trumps expert opinion" (almost all of the time). In other words, go down the hierarchy[0]. > I worked with

I think of EBM as "where stronger evidence exists it trumps expert opinion" (almost all of the time). In other words, go down the hierarchy[0]. > I worked with physicians who would examine and talk with a patient and tell me that something is not right and to do more extensive tests which would end up unearthing a hidden infection or other problem that we were able to treat before it caused major problems. Accordingly I don't view this as discordant with an evidence based medicine practice as you're not practicing in an area with clinical-trial evidence (and notably, expert opinion is evidence albeit weak). If you told me you did routine urinalysis and blood cultures on all your admissions I would view that as discordant and incorrect practice, regardless if expert dinosaur feels it saves lives in their experience. I also view EBM as opposed to "science-based medicine". Just because something has a (theoretical) scientific basis it does not meet the standard to enter my routine practice, I need stronger evidence for that which notably does not have to be in the form of a RCT as you suggest[0]. > How to apply the results of the large study to the individual patient in front of you is still more of an art than a science. Frankly, the practice of medicine is more art than science and EBM is a guiding principle that keeps us grounded to measurable outcomes. [0] https://en.wikipedia.org/wiki/Hierarchy_of_evidence https://en.wikipedia.org/wiki/Hierarchy_of_evidence