EBM+ is a consortium whose members are keen to develop the methods of evidence-based medicine to handle evidence of mechanisms in addition to evidence of associations.

What is EBM?

Causal claims are crucial in medicine. Bugs, injuries and environmental factors cause disease and other symptoms; medicines, other treatments and public health policies alleviate or prevent such problems. Evidence-based medicine is a collection of methods for evaluating the evidence for and against causal claims like these. It provides grading systems and hierarchies of evidence, to help weigh up the evidence and to help decide whether there is sufficient evidence to establish a causal claim.

What is EBM good at?

EBM is good at weighing statistical evidence of associations. Statistical trials are used to test whether there is an association between the putative cause and effect. These trials vary in size and methodology, and EBM has developed ways of ranking these statistical studies.

Why does EBM need developing?

Evidence of mechanisms also plays an important role in establishing causal claims. Such evidence is often crucial when it comes to devising a statistical study; interpreting its results; deciding whether an association is causal, due to some other sort of connection, or a statistical blip; or applying the results of a study to a new population or a particular individual. High quality evidence of mechanisms can be produced by statistical studies, but it can also come from literature searches, one-off experiments, imaging, simulations etc. At the moment, EBM does not take explicit account of the role of non-statistical evidence of mechanisms. Arguably, though, we need to take all relevant evidence into account, not just statistical evidence of associations.

Introductory reading: 

Brendan Clarke, Donald Gillies, Phyllis Illari, Federica Russo & Jon WilliamsonMechanisms and the Evidence HierarchyTopoi 33(2): 339-360, 2014.  


The consortium coordinator is Michael Wilde.