ABSTRACT
This chapter talks about the explanatory model by describing and critiquing its contemporary manifestation in the form of evidence-based medicine (EBM). It develops the argument that is unfolding in this book, from a justification of the proposition that science dominates the model to an exploration of the implications of that model for everyday general practice. The 'evidence' in EBM refers to a hierarchy in which the findings of fully randomised controlled trials are at the top, followed by less well-controlled trials, cohort studies, expert consensus views and authoritative opinion. The evidence suggested that the general practitioner uses time appropriately as a powerful diagnostic instrument. EBM encourages the critical appraisal of the best available evidence in order to solve clinical problems. The EBM Working Group argued that many patients are being denied the benefits of evidence from well-conducted clinical trials. Doctors conduct an inner consultation with biomedical evidence before deciding how to apply it.
