[Evidence-based recommendations : clinicians committed to the essentials but aware of the limits].

Abstract

The «Evidence-Based Medicine» (EBM) approach was born at the end of the last century in the English-speaking world. This article will briefly recall its essential contributions and reaffirm the importance of taking scientific data into account to support decisions. It will also describe the armful drifts observed in practice and the intrinsic limits of the approach. It will then discuss how the practice of EBM, from the consideration of the best available scientific data to the strict application of recommendations, can resonate with different ways of managing uncertainty. Finally, it will argue in favour of an «Evidence Based Practice» (EBP) approach that strengthens the critical skills of clinicians and targets share decision-making with patients.