Evidence-based medicine: NICE hints on day-to-day implementation*

Abstract

It is now generally accepted that sound evidence should underpin all decision making in health care. However, while research findings are necessary, they are rarely sufficient themselves in providing conclusive answers. This shortfall means that in order for clinical and policy decisions to be considered credible and valid, the process of reaching a conclusion has also to be transparent, consultative, inclusive and developmental. Successful implementation of evidence-based medicine on a daily basis requires a scientific approach moderated according to humanistic criteria. Using the initial experiences of the National Institute for Clinical Excellence (NICE), this paper describes the challenges faced by an organization undertaking this approach on a day-to-day basis. The principles underpinning this approach are in sympathy with a new emerging ethos of health care and hence provide a secure base for the future.