The uncertainty and incongruity of evidence-based healthcare

The ultimate purpose of the evidence-based health care movement is to improve patient care through the appropriate, timely, effective and personalised use of evidence by practitioners from every healthcare discipline. Indeed, Sackett et al.'s definition2 of evidence-based medicine (EBM) reminds us that the consideration of evidence from research is one dimension of a triad of intellectual analyses. The other two dimensions – often perceived as forgotten and awkward companions to the emergent giant of research evidence – are clinical experience and patient characteristics. The ultimate success of EBM as described by Sackett et al. is the internalisation of the evidence by the practitioner and its subsequent use in forming a clinical judgement leading to an appropriate, safe, timely and effective clinical action.