I think 'pure EBM' (as described above) would mean having a database into which a patient (or a broker for a patient) could type in their presenting problem with numerous other details, and the computer could find data that dictates the best treatment path for that 'individual' person. So after typing in their symptoms they may type in their:
Age, sex, height, weight, medical conditions, medications, eye colour, hair length, favourite food, the name of their dog
and the computer would generate a list of treatment options with percentages for success, as well as a list of side effects (and probability of developing them)
With regard to the overall thread, are we not sometimes referring to guidelines specifically, rather than evidence based medicine?? I certainly think that physicians often feel devalued when they feel they have to disregard their own training and follow a guideline. They can see it as being beneath them. I however, think that guidelines are a good thing.
And to a great extent I think that clinicians must cite 'evidence' to defend their treatment plans, because that is what the lawyers will asking for when they meet in court
