By Arlene S. Swern

One aspect of the current discussion regarding health care reform is the use of evidence-based medicine to determine the standard of care. The essence of evidence-based medicine, a concept first credited to David Sackett in 1997, is the idea that clinical decisions and the determination of standard of care need to be based on a careful and systematic scientific review of the medical and scientific literature. But what is considered standard of care or current evidence is a function of the studies that have been conducted at the time and ends up being an ever-changing story as new trials and meta-analyses are conducted, rather than an absolute “truth.”

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