1990

At McMaster University, Gordon Guyatt devises and uses term “evidence-based medicine”: “David Sackett popularized ‘critical appraisal’ to describe the process of assessing the literature according to explicit rules of evidence. . . . Guyatt took the next crucial steps in naming an approach in which clinical decisions were justified by reference to a systematic assessment of the medical literature” (J. Daly, 88). He first used the term scientific medicine, which drew strong criticism from colleagues who took it as implying that what they did was unscientific, so he switched to “evidence-based medicine”: “Since evidence is what clinical epidemiology produces, evidence-based medicine is the practical application of clinical epidemiology in patient care. The textbook, Evidence-Based Medicine: How to Practice and Teach EBM, was published in 1997 and revised in 2000 and has sold more than 70,000 copies (89). . . . With his fine focus on generating evidence that will produce more effective practices, he does, however, ignore evidence from social science that identifies the structural and professional determinants of clinical decision making” (91).