• Antonino Cartabellotta and Julie K Tilson.
• GIMBE Foundation, Via Amendola 2, 40121 Bologna, Italy. Electronic address: nino.cartabellotta@gimbe.org.
• J Clin Epidemiol. 2019 Jun 1; 110: 90-95.

AbstractEvidence-based medicine (EBM) has experienced numerous advances since its inception over 2 decades ago. Yet a persistent gulf remains between how medicine is actually practiced and the goal of providing care based on best available research evidence integrated with patient perspective and clinical expertise. A primary source of challenge for EBM is induced by inefficiencies in the generation, synthesis, and translation of evidence. During the 8th International Conference for Evidence-based Healthcare Teachers and Developers, GIMBE Foundation presented an innovative approach by defining an ecosystem of evidence. Based on the features of a natural ecosystem, the ecosystem of evidence is influenced by living organisms: stakeholders replete with competition and collaboration among and between them, as well as their conflicts of interest; the environment: social, cultural, economic, and/or political contexts; and nonliving components: scientific evidence, influenced by the rules, standards, and frameworks associated with evidence generation, synthesis, and translation. This article provides an analysis of the strengths and weaknesses of this ecosystem with a focus on nonliving components, specifically evidence generation, synthesis, and translation. Specific suggestions are outlined for building a stable and resilient ecosystem of evidence.Copyright © 2019 Elsevier Inc. All rights reserved.

16 keywords...

hide…