This paper is a narrative review of the concept of evidence-based medicine (EBM) and its application in the movement disorders field. The paper has three parts: 1. Discussion of the generic concept of EBM and of the most commonly voiced criticisms; explanation of how relevant are for the comprehension of EBM procedures the notion of implicit and explicit knowledge; discussion of the scientific basis of the hierarchical organization of the evidence and the recent challenges to it; the different robustness of data pertaining to efficacy and to safety. 2. Accessibility of the evidence relevant for the treatment of Parkinson disease. Description of the most relevant tools to bring unbiased data to the hands of the practicing physician; namely the product of Movement Disorders Cochane Review Group and the Movement Disorders Society Evidence-Based Review of Parkinson Disease treatments. The concept of management guidelines is presented along with commentaries to the potential variability of recommendations across the world. 3. Limitations of the clinical trials on Parkinson disease treatment so far available.
Copyright 2002 Elsevier Science Ltd.