The role of evidence-based medicine (EBM) in the delivery of healthcare in the 21st
century will be the subject of a public debate on March 31 featuring the doctor who
first coined the phrase and a leading researcher at the Mayo Clinic in Minnesota who
previously studied at McMaster University.

Gordon Guyatt, a leading advocate of EBM who coined the phrase in 1990, and Victor
Montori, who studied under Guyatt in the early 2000s and now conducts research into
how knowledge is produced, disseminated and taken up in medical practice, will
highlight the state of EBM in the debate from 7 p.m. to 8:30 p.m. in the DialogueSpace
on the fourth floor of Mills Memorial Library.

The event, which will include a question and answer period, has been organized by the
McMaster Health Forum Student Subcommittee.

EBM represents the judicious use of clinical evidence in making decisions about
individual patient care. Supporters of EBM argue that its integration of best research
evidence, physician expertise and patient values makes it an ideal model for guiding
clinical practice. They also suggest that it reduces variation among clinical practices,
discourages the use of unproven interventions, and brings consistency to clinical
guidelines.

Critics of the approach, however, suggest that EBM prioritizes experimental evidence
over pathophysiological presentation, case-specific histories, and clinicians'
observational expertise. They argue that EBM skews the autonomy of the doctor-
patient relationship by limiting the patient's ability to choose which treatment is best
for their unique circumstances. They also argue that EBM clashes with the framework of
many culturally-oriented, traditional approaches to healthcare.

Guyatt will argue in favour of the importance of the continuing prominence of EBM in
modern medicine, while Montori will suggest that the techniques of EBM should be
used within the context of a different approach. He advocates for an approach to
research and practice that reclaims a commitment to the patient, promoting a patient
revolution.

The debate is open to all students, faculty and staff at McMaster, as well as the
community. If interested in attending, please RSVP to mhf@mcmaster.ca with EBM
Debate in the subject line.

Guyatt is a professor in the Department of Clinical Epidemioloy and Biostatistics, and a
joint member in the Department of Medicine at McMaster. He has written extensively
on EBM, and is the primary editor of the Users' Guides to the Medical Literature, a
comprehensive set of journal articles and textbook for clinicians who wish to
incorporate EBM into their practice.

Montori is a professor of medicine at the Mayo Clinic College of Medicine, and
conducts research through Mayo's Knowledge and Evaluation Research Unit. His
interests focus on clinical decision-making in patients with chronic conditions, and the
relation between the quality of decision-making and patient outcomes, as well as
evidence-based clinical practice.

The debate is presented in partnership with the McMaster Alumni Association,
McMaster Student Union and the McMaster Medicine Student Council.