ABSTRACT
New ideas and paradigms can be threatening as they replace old ways of thinking and prompt change in our actions that engenders controversy among proponents and sceptics. Personalised medicine, like evidence-based medicine (EBM) before it, has generated its share of controversy. EBM challenged a traditional expert, opinion-based paradigm rooted in a theoretical understanding about mechanisms of disease as an implied justification for clinical interventions, to be replaced by direct observations from clinical experiments as an explicit basis for clinical decision making. While there remain criticisms of EBM, in general, the concept has become influential for decision making at the clinical, regulatory and policy levels.
