Abstract

The concept of 'evidence-based medicine' dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal 'evidence' in approving any form of health care provision. Essentially 'evidence-based medicine' aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the 'personalised medicine' in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of 'personalised health care' based on individual's genotype and phenotype. The first decade of the new millennium now witnesses the transition from 'evidence-based medicine' to the 'genomic medicine'. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the 'evidence-based medicine' to 'genomic medicine'.

Highlights

  • The philosophy behind the practice of ‘evidence-based medicine’ (EBM) is not new

  • Its philosophical origins date back to the mid-19th century Paris or even earlier (British Medical Journal 1996). Since it has been hotly debated by clinicians, public health practitioners, health planners and commissioners, politicians and the public

  • The recent upsurge and interest about EBM was triggered in 1991 at the McMaster University in Canada (Guyatt 1991) that led to the North American initiative for EBM (Evidence-Based Medicine Working Group 1992) and establishment of the British centres for evidence-based practice in Oxford and York with the Cochrane Collaboration (Grahame-Smith 1995; Lancet 1995)

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Summary

Introduction

The philosophy behind the practice of ‘evidence-based medicine’ (EBM) is not new. Its philosophical origins date back to the mid-19th century Paris or even earlier (British Medical Journal 1996). The importance of the evidence-based practice and teaching is reflected in its incorporation in the policy planning and implementation in both undergraduate and postgraduate medical teaching and training (Evidence-Based Medicine Working Group 1992; British Medical Association 1995; SCOPME 1994; General Medical Council 1994). The British health community and the public became interested in ‘evidence-based medicine’ when several articles and official government policy on medical education and training were published (British Medical Association 1995; General Medical Council 1994; House of Commons Health Committee 1995). It was followed by several key articles It is well known that several clinical applications did not stand the test of time as these were not properly evaluated through the process of adequately regulated translational

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