Evidence-Based Medicine (EBM) is a proposition and an area of study of medicine for which I am very fond. However, a few days ago, talking to some friends, I was confronted with a very critical approach to MBE and to Biostatistics itself.
"In 1992, the journal of the US Academy of Medicine announced the formulation of “a new approach to teaching the practice of medicine”. Known as Evidence-Based Medicine (EBM), it “emphasizes the examination of evidence provided by clinical research”, for which it “requires the application of formal rules to assess the evidence” (Guyatt et al., 1992).
A few years later, the scope of EBM had expanded considerably: “it is the meticulous, explicit, and sensible use of the best available evidence in making decisions regarding the care of the individual patient” (Sackett et al., 1996). For this purpose, the level of evidence is classified into categories, according to multiple criteria, among which, the statistical-mathematical measures to establish the chance that a certain effect is due or not to chance have a prominent place. Thus, concepts such as “frequency distributions”, “standard deviation”, “statistical significance” (usually measured as “p-value”), “correlation”, “regression” and “randomization” and tests such as “chi square”, “analysis of variance” and “Fisher's exact test” have become everyday tools, not only in clinical research, but in all areas of the biological and biomedical sciences.
The examples cited above are just a few of the many statistical concepts and methods used in EBM. However, they were not selected arbitrarily, but all of them were developed, among many others, between the end of the 19th century and the beginning of the 20th century by Karl Pearson (1857-1936) and Ronald A. Fisher (1890-1962). Both are considered the formulators of modern statistics, who developed according to a well-defined purpose: to improve the hereditary endowment of the Human race."
All fragments were taken from this book.
Available for free at https://www.fm.usp.br/museu/portal/livros-para-download (portuguese)
The tools that we use on a day to day basis to interrogate data and understand the world, were developed by white supremacists for the express purpose of demonstrating that white men are better than other people. In Statistics for Social Justice, we use statistical tools to expose and analyze racism in many aspects of society. Is this a contradiction?