Evidence‐informed person‐centred health care (part II): Are ‘cognitive biases plus’ underlying the EBM paradigm responsible for undermining the quality of evidence?

摘要: Introduction Recently, some leaders of the evidence-based medicine (EBM) movement drew attention to “unintended” negative consequences associated with EBM. The term ‘cognitive biases plus’ was introduced in part I encompass cognitive biases, conflicts interests, fallacies and certain behaviours. Hypothesis ‘Cognitive those closely involved creating promoting EBM paradigm are responsible for their (1) inability anticipate then recognize flaws tenets EBM; (2) discounting alternative views; (3) delaying reform. Methods A narrative review style used, methods as I. Appraisal literature Over past two decades there has been mounting qualitative quantitative methodological evidence suggest that faith placed hierarchy randomized controlled trials systematic reviews at summit; reliability biostatistical quantitate data; primacy sources pre-appraised evidence, is seriously misplaced. Consequently, informs person-centred care compromised. Discussion Arguments focusing on offered support our hypothesis. To best knowledge, proponents have not provided an explanation. Conclusions Reform urgently needed minimize continuing risks patients. If hypothesis correct, addition suggestions made I, deficiencies must be corrected. Meaningful solutions only possible if scientific inbreeding groupthink minimized by collaboration between who sounding warning bells.