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Evidence-based medicine versus evidence-based policy

‘Evidence-based medicine’ (EBM) has inspired a great number of clinical practice guidelines in many different fields, all aiming at improving the quality of patient care. Providing high quality care has become increasingly important, but also complex to define. Starting from the Donabedian’ triangle of structure, process and outcome, a framework for analysis of quality of care can be created? Structure is defined by characteristics of society and the healthcare system, but also by knowledge, skills and attitudes of healthcare providers and patients within the society. The process refers to all interventions and interactions between patients and providers, and outcome is related to the perception of illness and disease. The role of evidence-based medicine in this framework is restricted to improving the scientific rigour of clinical guidelines and protocols.