Evidence-based medicine: excessive attraction to efficiency and certainty?

Advocates of EBM deserve much credit for their efforts to increase the use of scientific evidence and economic evaluation in medical decision making. But EBM advocates' rigid requirements of certainty in the estimation of intervention effects may run counter to society's interest in maximising the expected benefits from resource use in health care. Also, their dedication to efficiency may lead some to overlook societal concerns for fairness in resource allocation.