IN THE 1990s evidence-based medicine emerged as a systematic method to evaluate clinical trials as a basis for formulating recommendations for clinical decision making. Emphasis on evidence-based methods developed in part from observations of wide variations in medical practice that reflected a reliance on clinical experience and the uncritical application of therapeutic modalities. It was anticipated that a more rigorous process that relied on a critical assessment of the medical literature together with development of clinical pathways, based on agreed on expert recommendations, would influence effective and efficient medical practice and yield favorable outcomes. Embodied in this goal was an implied improvement in the overall quality of care rendered to patients based on this scientific method.
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