A Better Way to Evaluate Evidence of Mechanisms in Medical Decision-Making

Abstract

A common criticism of Evidence-based Medicine (EBM) is that the guidance it provides tends to put too much weight on evidence from randomized trials, and too little on evidence of mechanisms.1-5 Nonetheless, the general advice regarding evidence of mechanisms and mechanistic reasoning provided within EBM has changed little since its inception.6 This is partly due to ongoing concerns regarding the appropriate role of mechanisms in the evaluation of medical evidence,7,8 and partly due to the absence of agreed frameworks for evaluating evidence of mechanisms and implementing this evidence into decision-making. Evaluating Evidence of Mechanisms in Medicine: Principles and Procedures seeks to address these issues. EBM has been successful in implementing the explicit evaluation of clinical research into practice, guideline development, and policy. Evaluating Evidence of Mechanisms in Medicine provides the resources to achieve a similar outcome for the explicit evaluation of evidence of mechanisms.