Evidence-Based Medicine (EBM) is heralded as a new paradigm of medicine. Is it? What is its link to epidemiology? Does an evidence-based (EB) approach apply also to other health sciences and to public health in particular? What has epidemiology already achieved in these domains, and what remains to be done? What should our priorities be in the coming years? The EB approach is essential in all health sciences at two levels: for problem solving, and for decision making. It applies to all health sciences, be it medicine, nursing, public health, or others. Many epidemiological principles, methods and techniques are put into good use in EBM. The EB "movement" is attractive in it's use of clearly defined procedures, generalizing (not always explicitly) the application of good epidemiologic principles, methods, and techniques. Epidemiology must now contribute to the evaluation of the practice of an EB approach. If one does not have access to a good medical library nor information technology does the EBM paradigm still hold? Hence, clinical and public health guidelines will benefit first from the EBM approach, then daily practice of EBM will follow, conditions permitting. In public health, the challenges of the EB practice are not equally spread across health protection, different levels of disease prevention, and health promotion. The latter represents the most challenging task for epidemiology at any step of EB approach. Epidemiology, if successful in this domain, may help to build an EB health promotion. An Evidence-Based Public Health paradigm may be considered.

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False positive blood culture results generate unnecessary hospitalizations, antibiotic therapy and use of microbiologic tests.

In the past 14 years, Evidence-Based Medicine (EBM) has enjoyed unprecedented developments and gained widespread acceptance among health professionals. However, should we be content with producing, critically appraising and using the best evidence available for our understanding of health problems and decision making about them? Are our convictions about EBM's relevance, our conviction and intellectual satisfaction with its mastery and adoption enough? Should we continue pushing forward along this promising path, or should we further diversify the content and scope of EBM? Is EBM the only way to view medicine in the near future? This paper presents some options to choose from in terms of direction and content as well as questions to answer given the current EBM crossroads. More intensive and extensive EBM combined with 'other features'-based medicines may be the preferred strategy to follow in the future to determine the development, use and evaluation of EBM. Argument-based medicine or Reasoned Medicine is one of the options that can be integrated into the mainstream of medical reasoning and decision making.