The pulse of paradigms: A journey towards change in medical science

Abstract

The history of medicine is a continuum of ideas and practices, characterized by progress, error rectification, and paradigm shifts. Drawing on Thomas Kuhn's concept of "paradigm shifts," this article examines the transition in medicine from a traditional paradigm, centered on clinical expertise and authority, to the Evidence-Based Medicine (EBM) and Clinical Epidemiology (CE) model.

Before the rise of EBM, medicine functioned as "normal science," relying on pathophysiological reasoning and academic authority. However, by the mid-20th century, anomalies such as diagnostic and treatment variability placed the limitations of the traditional paradigm under the spotlight. EBM introduced an evidence-based approach, emphasizing objectivity, reproducibility, and risk quantification in clinical decision-making.

Despite its advancements, this new paradigm faces significant criticisms. The proliferation of low-quality studies, scientific fraud, and a perceived detachment from the human sides of medicine are the new challenges. Nonetheless, EBM has redefined clinical practice, integrating rigorous scientific methodology with patient care. It has also transformed the doctor-patient relationship, enabling personalized treatment based on probabilistic risk assessments and patient preferences.

This article highlights the need to view clinical medicine as a journey marked by challenges in clinical practice, research, and scientific evidence in the ongoing pursuit of improving healthcare.