Abstract
Four of the five factors necessary for an innovation to take hold — compatibility with existing values and behaviours, lack of complexity, the ability to be subjected to experiment (trialability), and the ability to produce results everyone can see (observability) — are now present in regard to evidence-based medicine. The fifth factor — relative advantage — is only partly present, but it is becoming more prevalent.
Barriers include the failure of patients and doctors to differentiate between scientific training and scientific practice, to be seduced by technology and to be influenced more by pop-culture portraits of medicine than by the medical literature. Moreover, it has not yet clearly been demonstrated that it is to the economic or political advantage of any interest group to push for evidence-based medicine. Part of the reason is that there have been no easily identifiable victims to galvanise political pressure from the general public. Nonetheless, the situation is changing for the better.
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